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Dokumentation

RNC120AMBO - IS-H DE: P120 Trigger Special Events for Outpatient Surgery

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Description

You can use this program to create or cancel §301 orders for outpatient surgery in university outpatient clinics when using the alternative procedure (Ersatzverfahren) according to SGB V article 120 section 3.

Since the agreement stipulates that data transfer is to take place on a quarterly basis, the period for the last quarter is displayed by default. However, you can also choose a different period. The system determines all the outpatient cases whose first visit took place in this period.

You can further limit the group of cases determined using a predefined case selection (for example, selection by insurance providers) or by specifying case numbers.

The program then generates a corresponding §301 order record or cancellation record in table NC301 for each case, which is then processed the next time message formatting takes place.

When doing this, the system checks the following:

• Existence of an insurance relationship with an insurance provider for the case

• Validity of this insurance relationship for §301

• Data collection point for the insurance provider assigned to the insurance relationship

• Message exclusion for the insurance provider assigned to the insurance relationship

The system selects the cases for which the order record was created successfully in the list then displayed.

Otherwise, the list contains an error text column that displays an error message for the case in question.

Requirements

The §301 procedure should be active. Otherwise, the system issues a warning. If you ignore this message and continue processing, the system generates §301 messages for the cases in question.

To ensure that the events are triggered correctly, all the data relevant for §301, in particular the insurance relationships, must be defined correctly.

To execute this program, you need the authorization S_PROGRAM with the activity SUBMIT for the authorization group specified in the program attributes.

You must have authorization N_EINR_REP for the desired institution and the report. If you do not have this authorization for an institution, the system cannot output or change the data for this institution.

Output

• If you select Select Cases from List, the program does not automatically generate §301 order records for all the cases found. The cases in question are first listed and you can then select those for which you want to send a §301 message to the health insurers. You only have this option in online processing; the program does not take this option into account in background processing. Once you have made your selection, save the data to trigger the §301 orders. The next time program RNC30100 runs, it then generates corresponding §301 messages.

• The program option Generate Cancellation Orders allows you to generate cancellation orders for orders that have already been created. The next time program RNC30100 runs, it compares the existing orders with the cancellation orders.

• The Test Mode option is selected by default for the program. In test mode, the program does not generate the order records but simply lists the cases that match the selection criteria. Deselect this indicator if you want to generate orders.

Example

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