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Dokumentation

EXIT_SAPLN041_001 - IS-H SG: Estimation of Medisave Claim for Surgeries

CPI1466 during Backup   ROGBILLS - Synchronize billing plans  
This documentation is copyright by SAP AG.

Functionality

This function exist lets you perform your own estimation of the Medisave claim for surgeries.

The Medisave claim estimation is called both for the estimated invoice, and during each billing run if the confirmed claimed charges from Medisave are not yet available. The parameter SS_REPID is available for distinguishing these calls.

Besides the parameters for the institution and case, the module contains the following parameters that are filled differently depending on the calling program:

• SAPLN065 (estimated invoice):

• SS_OPTAB, SS_ICPMK and SS_ICPML are filled in accordance with the user input for the estimated invoice.

• SAPLNPD1 (billing):

• The procedures in the table SS_ICPMTAB (OPTAB, ICPML, ICPMK) are passed in this parameter. Those procedures that were used internally to determine the claim for surgeries are selected in the table (indicator MARK='X').

Further processing of value SS_OPCLAIM

The value you determine replaces the value determined internally. As regards the estimated invoice, no more modifications are made to this value. As far as billing is concerned, modifications can still occur:

If the total claim for services that are assigned to a surgery is less than the estimated value, the estimated value is reduced accordingly.

Example: The Medisave claim for surgeries was estimated to be $400. In actual fact, the total price of surgery-related services for the case amounts to $300. The Medisave claim is consequently reduced to $300.

Example

Notes

Use the following function modules to perform subsequent read operations on the database:

• Case data: ISH_READ_NFAL

• Patient data: ISH_READ_NPAT

• Service: ISH_READ_NLEI

• Assignments to procedures (services and diagnoses): ISH_READ_NICP_NLICZ_NDICZ

Further information

Parameters

SS_EINRI
SS_ESTDATE
SS_FALNR
SS_ICPMK
SS_ICPML
SS_ICPMTAB
SS_OPCLAIM
SS_OPTAB
SS_REPID

Exceptions

Function Group

XNMS

TXBHW - Original Tax Base Amount in Local Currency   PERFORM Short Reference  
This documentation is copyright by SAP AG.

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