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BAPI_PATCASE_GETCLAIM - IS-H BAPI PatientCase.GetClaim - Display Invoice Data

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Functionality

This BAPI returns the case-specific invoice data (claim) for an insurance provider.

Insurance Provider Specification

The data should to determined for an invoice addressed to a single insurance provider. The insurance provider can be specified either using its identification key (import parameter INSURANCE_PROVIDER) or its internal insurance provider category (import parameter INS_PROVIDER_TYPE).
If the insurance provider ID and an insurance provider category are passed to the method, the insurance provider ID is used for subsequent processing and the insurance provider category is ignored.

If only an insurance category is passed to the method, a check is run to ascertain whether there is only one insurance provider of this category for the specified case. If several insurance providers exist, processing is discontinued.

Invoice

A number of invoices can exist for a case and an insurance provider. All invoices are returned as header and item data.

Example

Several insurance relationships with the same insurance provider can exist for a case. For example, there might be an insurance relationship with OHIP (Ontario Health Insurance Plan) from 05/01/2001 thru 07/31/2001 with the contract scheme RMB (Reciprocal Medical Billing) and as of 08/01/2001 an insurance relationship with the contract scheme HCP (Health Claim Payment).

If services exist in both periods, two invoices are created for the same insurance provider, and can be transmitted as an electronic invoice.

Notes

Further information

Parameters

ADMISSION_DATA
BILL_HEADER_DATA
BILL_ITEM_DATA
BPART_SRV_LINK_DATA
CASE_DIAGNOSIS_DATA
CASE_PROCEDURE_DATA
CASE_SERVICE_DATA
INSTITUTION
INSURANCE_PROVIDER
INSURANCE_REL_DATA
INS_PROVIDER_TYPE
PATCASEID
PATIENT_DATA
PAT_ADDRESS_TABLE
PAT_PHONE_TABLE
PHYSICIAN_DATA
PHYS_SPECIAL_DATA
REF_HOSPITAL_DATA
RETURN
TESTRUN
WORST_RETURNED_MSGTY

Exceptions

Function Group

2097

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