Defining a Discount Arrangement Pricing Rule for a Parent Customer

Prerequisites

To define a discount arrangement pricing rule for a parent customer, you should have:

  • Pricing rule type where the category is set to Discount Arrangement.

  • Price items associated with the discount arrangement pricing rule type.

Procedure

To define a discount arrangement pricing rule for a parent customer:

  1. Search for a parent customer in the Customer 360° View screen.
  2. In the Search Results section, click the View (The View Icon) icon corresponding to the parent customer whose pricing details you want to view.
    The Person tab appears in the Customer 360° Information screen.
  3. Click the Pricing tab.
    The Pricing tab appears.
  4. Click the Add link in the upper-right corner of the Parent Customer Pricing Rules zone.

    The Pricing Rule screen appears. It contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Person Name Indicates the parent customer for whom you want to create a discount arrangement pricing rule type. Not applicable
    Person Type Indicates the type of the parent customer. The valid value is:

    • Parent Customer

    		 Not applicable
    Pricing Rule Type Used to indicate the pricing rule type using which you want to create a discount arrangement pricing rule. Yes
  5. Select the required pricing rule type in the respective field.
  6. Click OK.

    The Discount Arrangement Pricing Rule screen appears. It contains the following sections:

    • Customer Information - Displays information about the parent customer for whom you are defining the discount arrangement pricing rule. It contains the following fields:

      Field Name Field Description
      Parent Customer Information Indicates the parent customer for whom you are defining the discount arrangement pricing rule.
      Pricing Rule Type Indicates the pricing rule type using which you are defining the discount arrangement pricing rule.

    • Main - Used to specify basic details about the discount arrangement pricing rule.

    • Discount Details - Used to define eligibility criteria for a discount percentage and maximum discount amount which is allowed per claim.

    • Discount Limits - Used when you want to define minimum and maximum discount limit on the contract.

    • Exclusion - Used when you want to exclude certain network hospitals and providers during the discount share or discount guarantee calculation.

    • Characteristics - Used to define the characteristics for the discount arrangement pricing rule.

    Note: The Discount Details, Discount Limits, and Exclusion sections appear when you specify a price item in the Main section.

    The Main section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Price Item Used to indicate the price item for which you want to define the discount arrangement pricing rule. Yes
    Pricing Start Date Used to specify the date from when the discount arrangement pricing rule is effective.
    Note: The pricing start date cannot be later than the pricing end date.
    		 Yes
    Pricing End Date Used to specify the date till when the discount arrangement pricing rule is effective.
    Note: The pricing end date cannot be earlier than the pricing start date.
    		 No
    Rate Option Used to indicate the rate option that you want to use while defining the pricing for the price item. Yes
    Settlement Frequency Used to indicate the settlement frequency which helps to determine the bill after date. The valid values are:

    • Manually (At Regular Intervals) - If you select this option from the list, the bill after date which is specified in the Manual Settlement Bill After Date parameter while executing the C1-BCDA batch is stamped on the credit billable charge.

    • Yearly - If you select this option from the list, the bill after date in the credit billable charge is set to the pricing end date.

    Note: The bill after date is stamped on the credit billable charges and not on the discount billable charges.
    		 Yes
  7. Enter the required details in the Main section.
  8. Add the required discount details in the discount arrangement pricing rule.
  9. Define the minimum and maximum discount limits on the contract in the discount arrangement pricing rule, if required.
  10. Add the exclusion details of a network or a provider in the discount arrangement pricing rule, if required.
  11. Define characteristics for the discount arrangement pricing rule, if required.
  12. Click Save.
    The discount arrangement pricing rule is defined for the parent customer.

Related Topics

For more information on... See...
How to search for a parent customer Searching for a Person
Parent Customer Pricing Rules zone Parent Customer Pricing Rules
How to add the discount details in a discount arrangement pricing rule Adding the Discount Details in a Discount Arrangement Pricing Rule
How to define the discount limits in a discount arrangement pricing rule Defining the Discount Limits in a Discount Arrangement Pricing Rule
How to exclude a network or provider in a discount arrangement pricing rule Excluding a Network or Provider in a Discount Arrangement Pricing Rule
How to define a characteristic for a discount arrangement pricing rule Defining a Characteristic for a Discount Arrangement Pricing Rule