Claim
The Claim zone displays the details of the claim pricing rule for respective parent customer, bill group or a bill group using a pricing group. It contains the following sections:
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Main – Displays basic details of the claim pricing rule. It contains the following fields:
Field Name Field Description Parent Customer Information Displays the parent customer information. In addition, a context menu appears corresponding to this field which helps in navigating to other screens in the application. Note:It has a link. On clicking the link, the Person, Account or Policy screen appears where you can view the details of the parent customer.
This field appears only when the claim pricing rule is viewed for parent customer.
Bill Group Information Displays the bill group information. In addition, a context menu appears corresponding to this field which helps in navigating to other screens in the application. Note:It has a link. On clicking the link, the Person, Account or Policy screen appears where you can view the details of the bill group.
This field appears when the claim pricing rule is viewed for bill group.
Policy Information Displays the policy information. Note: It has a link. On clicking the link, the Policy screen appears where you can view the details of the policy.Pricing Rule Type Indicates the pricing rule type. Price Item Information Indicates the price item information. Note: It has a link. On clicking the link, the Price Item screen appears where you can view the details of the price item.Pricing Start Date Displays the claim pricing rule start date. Pricing End Date Displays the claim pricing rule end date. Rate Option Indicates the rate option of the claim pricing rule for the price item. Claim Template Indicates the claim template of the claim pricing rule. Pricing Group Displays the pricing group of the claim pricing rule. Note: This field appears when the claim pricing rule is viewed for pricing group. -
Claim Handling Fees – Lists the claim handling fees for line items in a claim pricing rule. It contains the following columns:
Column Name Column Description Fee Type Indicates the type of charge applicable on the line items. Fee Indicates the fee for the line items. Fee Significance Indicates the purpose of the imposing the additional fees on the line items. Fee Applicability Displays the fee applicability on which the claim handling fees are defined. Column Name Column Description Line Item Indicates the line item that you want to use while defining additional fees for the claim pricing rule. Rating Information Displays the rating information that you want to use while defining the rate for the line items. Column Name Column Description Rate Type Indicates the rate type that you want to use while defining the additional fees for the line items. Rate Used to specify the rate that you want to use while defining the additional fees for the line items. Note: This field is editable when the Editable checkbox is selected in the Rate column of the Additional Fees section while defining or editing the C1-ExtLookClaimTemplate extendable lookup. -
Markup or Markdown Values – Lists the markup or markdown values for line items in a claim pricing rule. It contains the following columns:
Column Name Column Description Pricing Strategy Indicates the pricing strategy. The valid values are: -
Markdown
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Markup
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None
Markup or Markdown Type Indicates the markup or markdown value type for claim pricing rule. The valid values are: -
Flat Amount
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Percentage
Markup or Markdown Amount Displays the markup or markdown amount. Rate Type Displays minimum and maximum markup or markdown defined using the rate type. Rate Displays the value for minimum and maximum markup or markdown defined using the rate type. -
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Line Items – This section contains the following fields:
Field Name Field Description Sequence Displays the sequence number for the line items. Line Item Displays the billing line items. Billing Eligibility Displays whether the line item is user defined, eligible or not eligible for billing. The valid values are: -
Eligible
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Not Eligible
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User Defined (Default Yes)
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User Defined (Default No)
User Defined Billing Option Displays whether the billing option is user defined, eligible or not eligible. Markup or Markdown Percentage Eligibility Displays whether the line item is eligible or not eligible for markup or markdown percentage. The valid values are: -
Eligible
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Not Eligible
Markup or Markdown Percentage Displays the percentage for markup or markdown value. Rating Information Displays the rating information that you want to use while defining the rate for the line items. Column Name Column Description Rate Type Indicates the rate type that you want to use while defining the rate for the line items. Rate Used to specify the rate that you want to use while defining the rate for the line items. Note: This field is editable when the Editable checkbox is selected in the Rate column of the Additional Fees section while defining or editing the C1-ExtLookClaimTemplate extendable lookup. -
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Characteristics – Lists the characteristics defined for the claim pricing rule. It contains the following columns:
Column Name Column Description Effective Date Displays the date from when the characteristic is effective for the claim pricing rule. Characteristic Type Indicates the characteristic type. Characteristic Value Displays the value of the characteristic type.
Related Topics
For more information on... | See... |
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How to view a claim pricing rule of a parent customer | Viewing a Claim Pricing Rule of a Parent Customer |
How to view a claim pricing rule of a bill group | Viewing a Claim Pricing Rule of a Bill Group |