Defining the Line Items in a Claim Pricing Rule

Procedure

To define the line items in a claim pricing rule:

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

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

    Field Name Field Description Mandatory (Yes or No)
    Sequence Displays the sequence number for the line items. Not applicable
    Line Item Displays the billing line items. Not applicable
    Billing Eligibility Displays whether the line item is user defined, eligible or not eligible for billing. The valid values are:

    • Eligible

    • Not Eligible

    • Rule Based

    • User Defined (Default No)

    • User Defined (Default Yes)

    		 Not applicable
    User Defined Billing Option Used to specify whether the billing option is user defined, eligible or not eligible for billing.
    Note:

    This option appears selected and disabled when the Billing Eligibility column displays either Eligible, Rule Based, or Not Eligible.

    This option appears selected and enabled when the Billing Eligibility column displays User Defined (Default Yes).

    This option appears unchecked and enabled when the Billing Eligibility column displays User Defined (Default No).

    		 Yes (Conditional)
    Note: This field is required when the Billing Eligibility column displays User Defined (Default No).
    Markup or Markdown Percentage Eligibility Indicates whether the line item is eligible or not eligible for markup or markdown percentage. The valid values are:

    • Eligible

    • Not Eligible

    		 Not applicable
    Markup or Markdown Percentage Used to specify the percentage for markup or markdown value.
    Note: This field is enabled when the Markup or Markdown Percentage Eligibility is Eligible and when the Markup or Markdown Type is Percentage.
    		 Yes (Conditional)
    Note: This field is required when Markup or Markdown Percentage Eligibility is Eligible and when the Markup or Markdown Type is Percentage
    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)
    Rate Type Indicates the rate type that you want to use while defining the rate for the line items. Not applicable
    Rate Used to specify the rate value that you want to use while defining the rate for the line items.
    Note: This field is editable when the Editable checkbox is selected in the Rating Information column of the Claim Handling Fees section while defining or editing the C1-ExtLookClaimTemplate extendable lookup.
    		 Yes
    		Yes
  2. Enter the required details in the Line Items section.
  3. If you want to define more than one line item for the claim pricing rule, 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 pricing rule, click the Delete (The Delete Icon) icon corresponding to the line item.
  4. Click Save.
    The line items are defined for the claim pricing rule.

Related Topics

For more information on... See...
How to define a claim pricing rule for a parent customer Defining a Claim Pricing Rule for a Parent Customer
How to edit the claim pricing rule for a parent customer Editing a Claim Pricing Rule of a Parent Customer