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Benefits, Services, and Fees Catalogs (New) ( RELNFSCM_472_SERVICECATA )
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Short text
Benefits, Services, and Fees Catalogs (New)
Use
As of Release 4.72 you can use a benefits, services, and fees catalog in the Claims Management system. At present these catalogs are only used in the lines of health insurance and care insurance.
If you use these catalogs, the following functionalities are available:
- Enter claim items using catalog items
- Automatic determination of the benefit type for the catalog item that has been entered
- Checks against catalog contents
A task level menu is available, permitting you to set up and maintain catalog contents. To do so, choose transaction ICLSCWM. Here you can assign a benefit type to a catalog item, for example.
You can also set up and maintain catalog contents via a direct input interface.
The table below shows the processes in which benefits/services/fees catalogs are used. X indicates the claim item grouping categories of these processes in which benefits/services/fees catalogs are used.
| Process | Rq | Prsc | CE | BD | Inv | PP |
|---|---|---|---|---|---|---|
| Medical devices | X | X | X | X | X | |
| Home health care | X | X | X | X | ||
| General process | X | X | X | X | ||
| Remedies | X | X | X | X | ||
| Dental treatment | X | X | ||||
| Dental restoration | X | X | X | X | ||
| Orthodontics | X | X | X | X | ||
| Pharmacy | X | X | ||||
| Hospital | X | X | ||||
| Rehab | X | X | ||||
| Care insurance | X | X | ||||
| Travel costs | X | X |
Legend for claim item grouping categories in above table:
Rq = Request
Prsc = Prescription
CE = cost estimate
BD = benefit decision
Inv = Invoice entry
PP = payment proposal
Effects on Existing Data
Effects on Data Transfer
Effects on System Administration
Effects on Customizing
In the Claims Management implementation guide (IMG) perform the IMG activities for benefits, services, and fees catalogs under Claims Management → Claim → Business Settings → Claim Item → Benefits, Services, and Fees Catalogs.
In IMG activity Configure Internal Claim Types, assign the benefits, services, and fees catalogs that you defined in IMG activity Define Benefits, Services, and Fees Catalogs to a subclaim type, depending on the internal claim type. This assignment takes place at subclaim level.
Further Information
BAL Application Log Documentation rdisp/max_wprun_time - Maximum work process run time
This documentation is copyright by SAP AG.
Length: 5682 Date: 20240603 Time: 093008 sap01-206 ( 46 ms )
