Bill After Date Determination

Once the billable charges are created for claim, claim based fees, enrollment based fees, and ancillary, the system enables you to automatically stamp the bill after date in these billable charges. The system can automatically stamp the bill after date in these billable charges when an algorithm created using the C1_BAFTDRV algorithm type is attached to the Bill After Date Determination system event of the respective pricing rule type. This algorithm sets the bill after date to the end date of the aggregation schedule period in which the transaction date falls. Note that the system considers the aggregation schedule specified in the rate option which is defined for the respective price item. Let us understand this with the help of an example. If the claim transaction with the transaction date set to 25-06-2018 is mapped to the following price item and account combinations:

The following table illustrates the schedule periods defined in an aggregation schedule which is specified in the rate option of a price item:
Pricing Rule Type	Price Item	Rate Option	Aggregate Transaction	Aggregation Schedule	Schedule Period	Account	Billable Charge
CLAIM	P1	R01	Yes	Monthly	01-01-2018 - 31-01-2018	A1	BC1
					01-02-2018 - 28-02-2018
					01-03-2018 - 31-03-2018
					01-04-2018 - 30-04-2018
					01-05-2018 - 31-05-2018
					01-06-2018 - 30-06-2018
					01-07-2018 - 31-07-2018
					01-08-2018 - 31-08-2018
	P2	R01			01-09-2018 - 30-09-2018	A2	BC2
					01-10-2018 - 31-10-2018
					01-11-2018 - 30-11-2018
					01-12-2018 - 31-12-2018
	P3	R02	Yes	Yearly	01-01-2018 - 31-12-2018	A3	BC3

Example 1: Bill After Date Determination Using the Aggregation Schedule

In the example 1, the system stamps 30-06-2018 as the bill after date in the BC1 and BC2 billable charges. This is because the transaction date (i.e. 25-06-2018) falls in the 01-06-2018 - 30-06-2018 period of the R01 aggregation schedule.

However, the system stamps 31-12-2018 as the bill after date in the BC3 billable charge. This is because the transaction date (i.e. 25-06-2018) falls in the 01-01-2018 - 31-12-2018 period of the R02 aggregation schedule.

Note: The bill after date for the specific stop-loss and aggregate stop-loss billable charges is calculated using the settlement frequency in the Create Specific Stop-Loss Billable Charge (C1-BCSSL) and Create Aggregate Stop-Loss Billable Charge (C1-BCASL) batches, respectively.