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Billing Column determination

Former Member

‎09-15-2011 1:41 PM

0 Kudos

Dear All,

I have a question, I have defined 2 column for the service and also have done the column determination ......

Now one column for the Insurance payer and other one for the payer.......

I have a 2 service....one service is assigned in the contract scheme and other service is not assigned......also I have the given the price of insurance payer as 100 and in self payer price column 50.....

Now when I am creating a case and assigning the 2 service so the system is showing me the price in way that : Insurance payer is 100 and payer is 0.....and when I am deactivating the insurance payer then its showing me the price of self payer is 50.....

System should have to behave in a way that Insurance payer for 1 service is 100 and the service which is not assigned should read the other column for 50.......

Can you please help me out in this????

Thanks & Regards,

Mohsin

2 REPLIES 2

Former Member

‎09-15-2011 2:49 PM

0 Kudos

Dear Mohammed,

I think your way not good for this scenario (but of course I don't know your requirements) ... but anyway: try to use a patient distribution process or an insurance verification process for that and maybe multiplication factor for a price of services ...

Could you please provide more details, what do you want to get in a result?

Regards, Alexander

SAP IS-H Solution Consultant

former_member198308
Active Participant

‎09-21-2011 7:53 PM

0 Kudos

Hi Mohsin

I analyzed the payment distribution process 10 years ago and one of the basic principles says that the Pricing is performed with insurance provider of highest rank. I think thats why when you activate the Insurer, the system always takes the price from the insurer.

Here is the info I have, but could be outdated.

Pricing is performed with insurance provider of highest rank

Payments are subsequently distributed among the insurance providers according to the rank

The amounts that are not covered by one insurance provider are passed to the following insurance relationship

The insurance provider with no contract scheme (usually the self-payer) will receive all the payments that could not be distributed earlier

I'm not an expert in payment distribution, anyway I hope it helps.

With best regards

Matías