Repricing
Oracle Revenue Management and Billing extends the Repricing feature for the insurance domain. To enable this feature for fully-insured line of business, you need to setup the audit framework for membership and age based and tier based pricing rules. For more information, refer to the Audit Framework for Membership and Fully-Insured Pricing Rules section.
To recalculate the membership premium, you need to execute the following batches in the specified order:
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Identify Entities for Repricing (C1-REPC1) - Until now, this batch identified a set of accounts which were impacted due to change in a price list and then created a repricing request for such accounts. In this release, new parameters named Repricing Mode and Membership ID are added in this batch. If the Repricing Mode parameter is set to ACCT, this batch identifies a set of accounts which were impacted due to change in a price list and then creates a repricing request for such account. However, if the Repricing Mode parameter is set to MEMB, this batch considers the records in the Pending (P) and Error (E) status from the CI_REPRC_ENTITY_DTL table. For each record, the system invokes the algorithms attached to the following system events of the pricing rule type in the specified order:
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Bill Group Derivation – Used to derives the policy, bill group, and parent customer of the bill group.
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Account and Price Item Derivation – Used to derive the pricing rules for the price items (which are present in the pricing rule type) on the policy plan (to which the membership belongs).
Once the pricing rules are derived, the system creates a repricing request for the membership, pricing rule, and effective date combination. Finally, the status of the corresponding record is set to Complete (C) in the CI_REPRC_ENTITY_DTL table. If any error occurs while creating a repricing request, the status of the corresponding record is set to Error (E) in the CI_REPRC_ENTITY_DTL table.
This batch is a multi-threaded batch. For more information about the batch, refer to Oracle Revenue Management and Billing Batch Guide.
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Process Repricing Request (C1-REPC2) - Until now, this batch calculated and persisted the rate for the account, price item, and effective date combination in the CI_PRCE_CALC table. In this release, new parameters named Repricing Mode and Membership ID are added in this batch. If the Repricing Mode parameter is set to ACCT, this batch calculates and persist the rate for the account, price item, and effective date combination in the CI_PRCE_CALC table. However, if the Repricing Mode parameter is set to MEMB, this batch considers the records in the Pending (P) and Error (E) status from the CI_REPRC_REQ_DTL table. If the pricing rule in the record is Age Based, the system invokes the algorithms attached to the following system events of the pricing rule type in the specified order:
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Pricing Rule Pre Processing – Used to identify the eligible member persons for premium calculation.
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Pricing Rule Premium Calculation – Used to calculate the premium for the membership.
Once these algorithms are executed, the premium is calculated for each eligible member person and stored in the CI_PRCE_CALC_LN table and the total premium for the membership is stored in the CI_PRCE_CALC table. Finally, the status of the corresponding record is set to Complete (C) in the CI_REPRC_REQ_DTL table.
However, if the pricing rule in the record is Tier Based, the system invokes the algorithm attached to the following system event of the pricing rule type:
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Pricing Rule Premium Calculation – Used to calculate the premium for the membership.
Once the algorithm is executed, the premium is calculated for the membership and stored in the CI_PRCE_CALC table. Finally, the status of the corresponding record is set to Complete (C) in the CI_REPRC_REQ_DTL table.
This batch is a multi-threaded batch. For more information about the batch, refer to Oracle Revenue Management and Billing Batch Guide.
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Related Topics
For more information on... | See... |
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Audit Framework for Fully-Insured Group Health Insurance Billing | Audit Framework for Fully-Insured Billing |
Bill Group Derivation for Membership | Bill Group Derivation for Membership |
Account and Price Item Derivation for Membership | Account and Price Item Derivation for Membership |
State of Issue | State of Issue |
Membership Premium Calculation | Membership Premium Calculation |
Fully-Insured Group Billable Charge Creation | Fully-Insured Billable Charge Creation |