Adding a Line Item in a Claim Template

Prerequisites

To add a line item in a claim template, you should have:

  • The line item defined in the C1-ExtLookPricingRuleLineItem extendable lookup.

  • Rule types defined in the application (where the rule type usage is set to ASO Billing Line Item Eligibility) when you want to define rule based billing eligibility for a line item.

Procedure

To add a line item in a claim template:

  1. Ensure that the Line Items section is expanded when you are defining, editing, or copying a claim template.

    The Line Items section contains the following fields in a grid:

    Field Name Field Description Mandatory (Yes or No)
    Sequence Used to indicate the order in which the calculation line should be generated for the line item. Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
    Line Item Used to indicate the line item that you want to include in the claim template.
    Note: The list includes only those line items which are associated to the Claim pricing rule type category.
    		 Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
    Billing Eligibility Used to indicate whether the line item is eligible for billing. If line item is not eligible for billing, the system does not create the calculation line for the line item. The valid values are:

    • Eligible - Used when the line item is eligible for billing.

    • Not Eligible - Used when the line item is not eligible for billing.

    • Rule Based - Used when you want to determine whether the line item is eligible for billing using certain business rules while executing the Update Status (C1-TXNEX) batch.

    • Used Defined (Default No) - Used when you want to define billing eligibility for the line item while defining a claim pricing rule using the claim template. If you select this option, by default, the User Defined Billing Option option is not selected for the line item in the claim pricing rule.

    • User Defined (Default Yes) - Used when you want to define billing eligibility for the line item while defining a claim pricing rule using the claim template. If you select this option, by default, the User Defined Billing Option option is selected for the line item in the claim pricing rule.

    		 Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
    Rule Type Used to indicate that rules of the specified rule type should be executed to determine whether the line item is eligible for billing.
    Note:

    The list includes only those rule types where the rule type usage is set to ASO Billing Line Item Eligibility.

    The values appear in this list when you select the Rule Based option from the Billing Eligibility list.

    		 Yes (Conditional)
    Note: This field is required when you select the Rule Based option from the Billing Eligibility list.
    Markup or Markdown Percentage Eligibility Used to indicate whether the line item is eligible for percentage based markup or markdown when the Markup or Markdown Type field is set to Percentage. The valid values are:

    • Eligible

    • Not Eligible

    		 Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
    Post-Processing Required Used to indicate that the line item is applicable for post-processing once the claim pricing rule is derived for a claim transaction. Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
    Rating Information Displays the rate type and rate value that you want to use while defining the rate for the line items.
    Field Name Field Description Mandatory (Yes or No)
    Editable Used to indicate that the rate type and rate value fields are editable while defining a claim pricing rule. Not applicable
    Rate Type Used to indicate the rate type that you want to use while defining the rate for the line items. Yes (Conditional)
    Note: This field is required when you define the rate from the respective field.
    Rate Used to specify the rate that you want to use while defining the rate for the line items. Yes (Conditional)
    Note: This field is required when you select the rate type from the respective field.
    		Yes (Conditional)
    Note: This field is required while adding a line item in the claim template.
  2. Enter the required details in the Line Items section.
  3. If you want to add more than one line item in the claim template, click the Add (The Add Icon) icon and then repeat step 2.
    Note: However, if you want to remove a line item from the claim template, click the Delete (The Delete Icon) icon corresponding to the line item.
  4. Click Save.
    The line item is added in the claim template.

Related Topics

For more information on... See...
How to define a claim template Defining a Claim Template
How to edit a claim template Editing a Claim Template
How to copy a claim template Copying a Claim Template