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SIMG_CFMENUNMOBONV7 - Define Insurance Provider Types

General Material Data CPI1466 during Backup
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In this Customizing activity, you define insurance provider types. When maintaining master data, you can assign an insurance provider to an insurance provider type. This enables you to combine insurance providers of the same type in groups.

The parameters related to the insurance provider type enable you to control function sequences, which, alternatively, can also be controlled via the individual insurance providers. In addition, reference can be made to insurance provider types (instead of to the individual insurance providers) in control tables when insurance verification and invoicing are carried out.

IPT	Description
AOK	General health insurance program
BB	German Federal Railways
IKK	Guild insurance fund
PR	Private health insurance

Entries for common insurance provider types in Germany (AOK, BB, etc.) are delivered in the standard system. These can be added to, or modified.

You define an insurance provider type by specifying the following data:

User-definable key (3-character. alphanumeric) in the IPT field

Description in the Ins. Prov. Type Text field

Short text in the IP Type Short Text field

You can make further specifications on the detail screen:

Whether the insurance verification procedure is to be used or not (IV Procedure indicator)

Period (number of days) for which cost coverage is to be automatically checked in an IV request (IV Request Interval field). You can change default end date determined from this specification. If no entry is made, the system sets the end date to "12/31/9999".

Whether a referral or admission diagnosis is required for the insurance verification requests to be printed. If printout is conditioned by such a diagnosis, select Diagnosis Required.

Period (number of days) for which service coverage is to be automatically checked in the case of an extension IV request in the IV Request Extension field. If no entry is made, the system sets the end date to "12/31/9999".

Whether the reminder procedure should be triggered if an IV request goes unanswered. To activate this procedure, select IV Reminder.

Deadline (number of days as of the IV request send date) after which the reminder procedure can be triggered for outstanding insurance verification requests. You enter the corresponding number of days in the Reminder After x Dys field.

Whether an invoice list is to be printed per insurance provider (collective invoice without separate collective invoice number) when the invoice print function is executed (Invoice List per IP indicator).

Radio buttons for invoice printout let you control whether single invoices only, collective invoices only, single and collective invoices, or no invoices should be printed for an insurance provider. These radio buttons have the following labels:

Single Invoice Only

Cllct. Invoice only

Invoice Only

Single + Cllct.

Number of days after which interim billing can take place (calculated from the admission date) in the I.Bill. After x Days field

You specify whether services for which there is no confirmation of coverage can be invoiced in final billing runs (Fin.Billing w/o CoC indicator).

You specify whether services for which there is no confirmation of coverage can be invoiced in interim billing runs (Int.Billing w/o CoC indicator).

You specify whether a discharge diagnosis is required in order to perform final billing (Fin. Bill. Diagnosis indicator; if this indicator is selected, a discharge diagnosis is required).

You specify whether separate invoices are to be created for assigned cases (for example, companions, newborns) (Separate Invoice indicator).