Ansicht
Dokumentation

ISH_HCM_301_DO_CUST - DE: §301 Customizing

ABAP Short Reference   BAL_S_LOG - Application Log: Log header data  
This documentation is copyright by SAP AG.

This IMG activity is relevant for the country version Germany only.

Procedure for Implementing §301 Data Exchange (Germany)

1. Maintain the institute indicator of health insurance companies/ insurance providers

Of particular importance to the EDI procedure is the correct specification of the institute indicator for each participating insurance provider. You have to specify this number in the Inst. ind. field.
You can obtain a corresponding overview (and branch directly into the insurance provider maintenance function) by means of the EDI utility RNC301U1. For more information, please refer to the program documentation.
Before proceeding to assign data collection points, please first refer to the corresponding topic below.

1. Create the data collection points: Master data maintenance

You must first create the data collection point before being able to assign it to an insurance provider. You do this in Maintain master data of data collection points.

Create all third-party data collection points before creating the decoding data collection points. This way you can assign the correct third-party collection points to the decoding collection points right away.

1. Maintain insurance provider - data collection point assignment

Once the data collection points have been created, they have to be assigned to the insurance providers. For this purpose the DKG provides a CD with a complete insurance provider and hospital directory together with all assignment information for data collection points. This database is called ISD301 and can be obtained only from the DKG in Düsseldorf (www.dktig.de).

By means of program RNC301C3 you can assign insurance providers to data collection points on the basis of this file. Please read the program documentation, since you must create a data extract beforehand.

The following two alternatives also exist:

1. By means of the EDI utility RNC301C1, you can store data collection points for selected insurance providers. This means you do not have to maintain each insurance provider individually (see second alternative). Please refer to the program documentation. You can branch into this maintenance activity from the EDI Utility RNC01U1 mentioned above.
2. You can access a general maintenance transaction (transaction code ONCEDI5) from the Communication area level menu by choosing EDI -> Data collection point -> Insurance provider asgmt -> Change. Here you can modify, delete or add all assignments.
   
   

Activate data collection

Data transfer via EDI has to be explicitly activated in the system. You activate this option in the Customizing activity Activate communication procedure. In the corresponding Customizing table you can specify for which communication procedure you want to carry out data exchange. For Germany, only data exchange according to §301 is relevant. For this, please specify the current institution and the procedure P301.

Please note that the previously used parameter Activate EDI in the institution control parameter table is no longer evaluated.
You should activate data collection only if data exchange takes place electronically. On no account activate this file creation if you are still exchanging data with health insurance companies using forms (or any other means).
If you set this flag, corresponding background processing tasks must be installed (see below).

1. File receipt and error processing

Program RNC301I0 takes charge of file receipt. In general, you should schedule this program to run on a regular basis (for instance, every evening). However, you can also execute it explicitly should you want to read and process messages for a particular institution or data collection point, for example.

After opening or reading the file whose name is dynamically determined from table NC301B (using the DCP-related sequential number of the file) the program performs a check according to error level 1 (correct order and syntax of service segments).

If errors occur at this stage, a new order record in written to table NC301. This record will then be transmitted as an error message of the type 'FEHL' to the health insurance company.

If the file structure is correct, the individual messages are processed. Each message is split up into single fields using the agreed field separator and is then transferred to the application where it is written to the database. If errors occur at this point, an order record is similarly created in table NC301. This is then used to generate an error message that is transmitted to the health insurance company.

If internal errors occur, the messages are saved in table NC301W. Messages in which temporary errors (due to lock problems, for example) occurred can be postprocessed using program RNC301I1. Messages containing other internal errors have to be checked by a clerk. You can display these incorrect messages using program RNC301I2. This program also lists the messages from the health insurance companies that are not directly processed by the IS-H System in a batch input session (e.g. medical grounds and payment records).

1. Maintain case exclusions

In production operation, it may be agreed with the responsible health insurance company that data relating to complicated cases should be communicated in paper form only. To prevent messages from being created and processed in such situations, you have to add the corresponding cases to the EDI case exclusion table. You can also create a short explanatory text for these entries.

You can maintain EDI case exclusions by choosing Hospital -> Communication -> EDI -> Exclude -> Case.

1. Exclude messages for insurance providers

In test operation, you may be required not to use various message types with particular insurance providers. This is most likely to be the case in the start-up period. Should a specific message not be used in the electronic data interchange procedure with an insurance provider, enter the appropriate message-to-insurance provider assignment in the exclusion table.

You can exclude EDI messages for specific insurance providers by choosing Hospital -> Communication -> EDI -> Exclude -> Message for insurance provider.

1. Activate HCM Monitor checks

It is practical to activate at least the standard background checks for EDI processing provided in the HCM monitor. For information on how to proceed, see Maintain monitoring checks.

1. EDI workbench

You access the central EDI workbench by choosing Hospital -> Communication -> EDI -> EDI workbench. Alternatively, you can execute transaction NCW3. This transaction provides an overview of the current status of EDI data transfer within your system. You can branch directly into all maintenance transactions from this overview screen. SAP recommends this transaction for central EDI control.

rdisp/max_wprun_time - Maximum work process run time   RFUMSV00 - Advance Return for Tax on Sales/Purchases  
This documentation is copyright by SAP AG.

Length: 8428 Date: 20240420 Time: 014419     sap01-206 ( 152 ms )