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RNWCHHONAUFEA - Breakdown of Fee-Based Services for External Orders

RNWCHHONAUFEA - Breakdown of Fee-Based Services for External Orders

General Data in Customer Master   General Material Data  
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Description

This report is used to break down fee-based services from external orders. Once it has been executed successfully, the system changes the status of the fee-based services in the fee database (from 'Entered Manually' or 'Transferred' to 'Breakdown' and from 'To Be Canceled' to 'Canceled') and also writes the limit with which breakdown took place to the fee-based service. The program writes the new fee results to the fee results table.

Requirements

Entry on initial screen:

  • Institution
  • Service Performance Date From/To
The fee-based services are selected according to the service performance date specified in the fee-based services. Where services have been transferred, this date is the performance date of the standard IS-H service. In the case of fee-based services that were entered manually, it is the date entered by the user in the Service Rendering Date field.
  • Billing Date From/To
Breakdown then only takes place for services billed during the specified period.
  • Payment Date From/To
You can only make entries in these fields if breakdown is taking place according to the paid principle. The report only breaks down services with an invoice that was cleared during the specified period.
  • Fee Issuer From/To
You can perform breakdown for one or more physicians.
  • "Check for Missing Limit Mod." checkbox
This checkbox is not visible in the country version Austria. You can use it to decide whether the system is to cancel or continue processing if it does not find a suitable limit model for the physician and breakdown code. If processing is to continue, the system breaks down the fee-based service as if there were no limit ("NOLIMIT") for this physician and breakdown code.
  • Breakdown Date
Enter the breakdown date here. For example, you could specify the last day of the previous month as the breakdown date.
  • Comment
In this field, enter a comment that will allow you to identify the breakdown run (job number) later on, such as "Fees January 2002". This text is stored for the fee breakdown job number and is also displayed in the value help.
  • "Test Run" indicator
The system executes the breakdown like an update run but does not make changes to the database.

Please note the following when making entries on the initial screen:

  • You must enter a breakdown date, since the pool breakdown and fee posting both use this date for selection.
  • The breakdown date must be the same as the service rendering or billing date or later (for example, if you specify 01/01-01/31 as the service rendering date, the breakdown date must be 01/31 at the earliest).
  • You can only enter a payment date if the system parameter "Fee Breakdown Principle" has the value B.

Settings Required for Fee Breakdown:

  • Fee Breakdown Principle: This time-dependent system parameter for the institution determines whether fee-based services can be broken down once they have been billed, or whether the invoice has to be paid in full first.
  • Fee Breakdown by Date: This time-dependent system parameter for the institution determines whether the fee breakdown keys need to be valid on the breakdown date or service rendering date. This means that the system selects the fee breakdown keys for the breakdown or service rendering date, depending on the Customizing settings.

Prerequisites for including fee-based services in breakdown:

  • Depending on the fee breakdown principle, the invoice may have to be paid before the fee-based services can be included in the breakdown.
  • The block indicator must not be selected for the fee-based services (in the case of changed fee-based services, the block indicator is reset when fee-based services are released in editing).
  • If the fee physician to whom the fee-based service is assigned has a fee block that is active at the fee breakdown time, the system does not break down the fee-based service. Instead, the service remains unchanged in the fee database until the physician's fee block expires.
  • If there is an amount left over after breakdown, the fee-based service in question is then not broken down, but instead remains unchanged in the fee database and is listed in an error log.
  • If the system is unable to determine an entry during account determination for a fee-based service, the service in question is not broken down, but instead remains unchanged in the fee database and is listed in an error log.

In fee breakdown, you should also note that fee results with a breakdown indicator that has the receipt type 'W' (further breakdown) are broken down again straight away. Breakdown indicators with receipt type 'P' (pool) are not broken down again until pool breakdown takes place.

Processing

The system performs fee breakdown for the services that meet your selection criteria. Breakdown takes place according to the breakdown code assigned. The system determines whether the service date or the breakdown date is to be used to determine the recipients in the breakdown code from your entry for the Fee Breakdown by Date parameter (HONAN_CH). The Fee Breakdown Principle parameter (HONAP_CH) indicates whether the fee breakdown is to take place according to the agreed principle (here, invoicing is the prerequisite) or paid principle (payment of the invoice is the prerequisite here). The system also processes all the fee-based services that are to be canceled. These are only restricted according to the physicians entered. Criteria such as the service rendering date or billing or payment date are not taken into account during selection. When you execute the program as an update run, the system places the fee results in the table and adjusts the fee-based services processed accordingly (changing the status and adding the limit).

Output

The first results list is a log indicating all the issuing fee physicians involved in the breakdown and the total fees they distributed. In addition, this log lists the greatest and smallest rounding difference for you to check. Check the rounding difference and if it is relatively large, do NOT perform fee breakdown as an update run, but check the data first.

After these two logs, the report displays a variety of error logs:

  • Log of errored breakdown codes/pools
  • Log of invoices without document number
  • Log of fee-based services for which an expense account was not found
  • Log containing a number of error messages; the errors are listed in the log (for example, "No breakdown codes found" or "Main vendor missing in TNWCH94").

The second list, which you can access by choosing the "Breakdown Log" button, first lists the log with the totals per issuing fee physician and the rounding difference. This is followed by a list of fee-based services for which breakdown took place, as well as the fee results.

Example






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This documentation is copyright by SAP AG.

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