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Insurance Relationship: Third-Party Payer (New) ( RELNISH_472_VV_A4 )

ABAP Short Reference   RFUMSV00 - Advance Return for Tax on Sales/Purchases  
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Short text

Insurance Relationship: Third-Party Payer (New)

Use

The new third-party payer concept replaces the alternative invoice recipient concept in the self-payer insurance relationship.

Previously, you were able to depict an invoice recipient that was neither the self-payer nor the insurance provider in two ways:

• By overwriting the patient's customer data for an invoice

• By using a one-time account.

The new third -party payer concept enables you to invoice all or part of the costs for a case to a third party that is neither the patient him-/ or herself nor the insurance provider. You can create this "third-party payer" as a customer, or specify an existing customer as a third-party payer.

You can assign one self-payer or one third-party payer to each case. However, any number of third-party payers can be created in the proposal pool.

Example: A parent pays the invoice or part of the invoice for his or her child's hospital treatment. If the mother and the father take turns at paying the child's self-payer contribution, you can define the mother and father as the child's third-party payers in the proposal pool.

Effects on Existing Data

Effects on Data Transfer

Effects on System Administration

Effects on Customizing

If you want to use the alternative invoice recipient rather than the third-party payer, you have to set the No 3rdP Payer indicator (No Third-Party Payer) for your institution in the IMG activity Maintain Settings for Insurance Relationships. Note that SAP will no longer support the alternative invoice recipient function in the medium term.

For information about this, see the Implementation Guide under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting -> Business Partners/Insurance Relationships -> Maintain Settings for Insurance Relationships.

In Customizing for SAP Patient Management, new parameters have been added to enable the creation of the third-party payer customer in the IMG activity Preset Values for FI Customers. The parameter names for the third-party payer each end in "_FR". Note that you must assign a number range with internal number assignment to the account group used for third-party payers.

For information about this, see the Implementation Guide under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting -> FI Customers -> Preset Values for FI Customers.

For the third-party payer, the system calls the user exit that is storedfor the KNA1_SZ parameter in the IMG activity Define Function Modules for Presetting FI Data. The PATKZ field has been added to the interface parameter RNG99. Its value is 'X' if a patient customer is concerned and initial if a third-party payer is concerned. Note that the function module is called several times for self-payer customers as well as for third-party payer customers as part of the new insurance relationship maintenance process.

For information about this, see the Implementation Guide under SAP Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting -> FI Customers -> Define Function Modules for Presetting FI Data.

Further Information

SUBST_MERGE_LIST - merge external lists to one complete list with #if... logic for R3up   General Data in Customer Master  
This documentation is copyright by SAP AG.

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