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ISH_SG_MEDISAVE_EST - SG: Medisave Claim Estimation

ISH_SG_MEDISAVE_EST - SG: Medisave Claim Estimation

CL_GUI_FRONTEND_SERVICES - Frontend Services   BAL_S_LOG - Application Log: Log header data  
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Specifications relating to Medisave payments are required at various times during a patient's stay in your healthcare facility. However, this data is not transmitted to Medisave until the patient has been discharged. Consequently, confirmation of coverage by Medisave is not available at any time during the patient's stay. The expected Medisave payments must always be estimated.

In this IMG activity, you set the parameters that are relevant for the Medisave estimation. These parameters are institution-specific and time-dependent. The valid currency for all currency fields is the local currency of the institution.

  • Group box Inpatient Cases
  • Field Daily Charge (daily charge for inpatient cases)

  • Field Phy. Fees (limit for physician's daily attendance fees for inpatient cases)

  • Group box Day Surgery Cases
  • Field Daily Charge (daily charge for day surgery cases)

  • Field Phy. Fees (limit for physician's daily attendance fees for day surgery cases)

  • Group box Psychiatric Cases
  • Field Daily Charge (daily charge for psychiatric cases)

  • Field Phy. Fees (limit for physician's daily attendance fees for psychiatric cases)

  • Group box Vaccinations
  • Amounts for hepatitis vaccinations in relation to three different age-groups

  • Group box Live Birth Restrictions
  • Restrictions for the number of living children delivered for obstetric cases and ligation

  • Group box Max.Amount field specifies the maximum Medisave
  • withdrawal with respect to surgical procedures.

  • Medisave claims shall:

  • Be limited to not more than three surgical procedures

  • Be limited to procedures involving not more than two anatomical systems (i.e. codes SA - SY) as defined in Tables of Surgical Operations; and not more than two procedures within each system

  • By subject to a maximum Medisave withdrawal of $XYZ for the total operations charges.

With the action Maintain Tables of Operation you specify for each table of operation an amount claimable from Medisave.

  • When delimiting the validity of these parameters make sure that the entries neither overlap nor leave a gap in coverage.
Example:
  • Entries with two intervals 01/01/2000 - 06/30/2006 and 06/01/2006 - 12/31/9999 and an entry with two intervals 01/01/2006 - 05/30/2006 and 07/01/2006 - 12/31/9999 would be illegal.

  • The correct solution would be to create an entry with the intervals 01/01/2006 - 06/30/2006 and 07/01/2006 - 12/31/9999.






ROGBILLS - Synchronize billing plans   General Data in Customer Master  
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