Discount Pricing

The Administrative Services Only (ASO) provider may offer some discounts to its network hospitals and providers. A portion of these discounts is then charged to the self-funded employer. Oracle Revenue Management and Billing enables you to calculate and bill the discount share or discount guarantee amount to the self-funded employer. The system enables you to calculate the discount using the following methods:

• Discount Share
• Discount Guarantee

The pricing for the share or guarantee discount can be defined using the respective discount pricing rules. You can define a share or guarantee discount pricing rule only at the parent customer level. You can define the share or guarantee discount pricing rules for parent customers from the Customer 360° Information screen. You can define a share or guarantee discount pricing rule using a discount arrangement pricing rule type.

Once a discount arrangement pricing rule type is defined, you can create discount pricing rules using the discount arrangement pricing rule type. Once a discount pricing rule is created, the system creates multiple price assignments in a price list and assigns the price list to the parent customer.

The following new batches are introduced in this release:

• C1-ACDA - Once the transaction legs and calculation lines are created for discount, this batch is used to accumulate the discount. It also calculates the required minimum or maximum limit on the contract. For more information about the batch refer to Oracle Revenue Management and Billing Batch Guide.

• C1-BCDA - Once the discount is accumulated, this batch is used to create the credit (if any) and discount billable charges. It is also used to calculate the bill after date. For more information about the batch refer to Oracle Revenue Management and Billing Batch Guide.

Related Topics

Parent Topic: Self-Funded Pricing