C1-PIRECOCIL

This algorithm is invoked when the status of the pay instruction is changed to Reconciliation in Progress. It searches whether there is an open bill segment with the policy, plan, member, and coverage period combination for the payee account. If such bill segment exists in the system, this algorithm reconciles the pay instruction against the open bill segment. It creates two reconciliation adjustments - one against the payee account's reconciliation contract and another against the bill segment's contract.

If the amount on the pay instruction is fully reconciled, then the status of the pay instruction is changed to Completed. However, if the amount on the pay instruction is not fully reconciled, then the status of the pay instruction is changed to Open.

It contains the following parameters:

  • Pay Instruction Matching Level Characteristic Type - Used to specify the characteristic type which indicates whether the pay instruction must be reconciled at the member, plan, or policy level. This type of characteristic is defined on the pay instruction. Here, you must specify a characteristic type where the characteristic entity is set to Payment Instruction.

  • Member Matching Level Characteristic Value - Used to specify the value of the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter which indicates that the pay instruction must be reconciled at the member level.

  • Plan Matching Level Characteristic Value - Used to specify the value of the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter which indicates that the pay instruction must be reconciled at the policy plan level.

  • Policy Matching Level Characteristic Value - Used to specify the value of the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter which indicates that the pay instruction must be reconciled at the policy level.

  • Adjustment Type for Bill Segment Contract - Used to specify the adjustment type using which you want to create the adjustment on the bill segment's contract when the pay instruction is reconciled.

  • Adjustment Type for Reconciliation Contract - Used to specify the adjustment type using which you want to create the adjustment on the reconciliation contract when the pay instruction is reconciled.

  • Reconciliation Open Status - Used to specify the status code to which you want to transition the reconciliation when the status of the pay instruction is changed to Open.

  • Pay Instruction Open Status - Used to specify the status code to which you want to transition the pay instruction when it is not fully reconciled.

  • Pay Instruction Completed Status - Used to specify the status code to which you want to transition the pay instruction when it is fully reconciled.

  • Reconciliation Characteristic Type - Used to specify the characteristic type which you want to use to store the reconciliation ID. This type of characteristic is defined on the adjustments which are created on reconciliation. Here, you must specify a characteristic type where the characteristic entity is set to Adjustment Type.

  • Payment Event Characteristic Type - Used to specify the characteristic type which you want to use to store the payment event ID. This type of characteristic is defined on the reconciliation adjustments to indicate the payment event whose payment is distributed against the bill segment.

  • Adjustment Type for Offsetting Debits against Billed Credits - Used to specify the adjustment type using which you want to create the adjustments when offsetting billed debit verses billed credits.

All these parameters are mandatory.