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ISH_ZUZ_BETRAG_OUTP - Maintain Copayment Amount for Insurance Provider

ISH_ZUZ_BETRAG_OUTP - Maintain Copayment Amount for Insurance Provider

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In this IMG activity, you define the copayment amount for each outpatient visit. You need the copayment amount as a default value for each visit in the Outpatient Copayment subscreen of the Clinical Process Builder. Alternatively, you can directly enter an amount in the subscreen.

You can define the copayment amount dependent on the insurance provider type or an insurance provider. Since the table is institution-dependent you can define different copayment amounts for different institutions.

To maintain the copayment amount dependent on the insurance provider, clarify the following questions beforehand:

  • Which copayment amounts apply in which period for the insurance providers that require copayment?
  • Are there different copayment amounts for insurance providers?
If this is the case, find out which amounts you need to specify dependent on the insurance provider type and which amounts you need to specify for individual insurance providers.

The table contains two fields for the copayment amount. Enter the amount for the outpatient copayment either in the Amount 1 field, and select the A1 radio button, or in the Amount 2 field and select the A2radio button.

In the U (Use) field, specify for what purpose the copayment amount is used:

  • D2: Statutory copayment obligation for outpatient Panel Physician Association cases (Germany)
  • D3: Outpatient Panel Dentist Association cases
  • D4: Cases with outpatient surgeries

The copayment amount is time-dependent. Ensure that the periods do not overlap.

Note

You can store a currency for each period. Note that it is not recommended to create identical periods in different currencies. Since the currency in this table is used for the automatic generation of copayment requests, it must be unique for each period.






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