Editing an Ancillary Pricing Rule Type

Prerequisites

To edit an ancillary pricing rule type, you should have:

  • Ancillary pricing rule type business object defined in the application.

  • Ancillary pricing rule business object defined in the application.

Procedure

To edit an ancillary pricing rule type:

  1. Click the Admin link in the Application toolbar.
    A list appears.
  2. From the Admin menu, select P and then click Pricing Rule Type.
    A sub-menu appears.
  3. Click the Search option from the Pricing Rule Type sub-menu.
    The Pricing Rule Type screen appears.
  4. In the Pricing Rule Type List zone, click the Edit (The Edit Icon) icon in the Edit column corresponding to an ancillary pricing rule type whose details you want to edit.

    The Ancillary Pricing Rule Type screen appears. It contains the following sections:

    • Main - Used to specify basic details about the ancillary pricing rule type.

    • Related Pricing Rule Types - Used to indicate the non-primary pricing rule types which should inherit the transaction field mapping details from the ancillary pricing rule type. You can add a pricing rule type which belongs to the following category:

      1. Retention Type Claim Based

      2. Discount Arrangement

      3. Specific Stop-Loss

      4. Aggregate Stop-Loss

      5. Level Funding

      Note: We recommend you to add the required related pricing rule types in the above specified sequence. Otherwise, erroneous results might occur.
    • Transaction Field Mapping - Used to map the transaction fields in a claim transaction to the appropriate fields in the claim pricing rule type. This helps the system to determine the field where the data from the transaction field must be stored. This data is then used in the system for various reasons, such as for deriving a bill group and pricing, deriving an effective related pricing rule, and so on.
      Note: The Billing Eligibility Identifier field is required when you are defining the Transaction Field Mapping for the ancillary pricing rule type.

    • Algorithms - Used to associate the algorithms with the ancillary pricing rule type.

    • Additional Data - Used to specify the additional information about the ancillary pricing rule type.

    • Price Items - Used to add the price items for which you can define the ancillary pricing rules using the ancillary pricing rule type.

    • Price Item Parameters - Used to add the price item parameters based on which you want to define the price item pricing.
      Note: There are two price item parameters that are mandatory in the ancillary pricing rule type:

      • A price item which stores the billable charge line type from the ancillary transaction.

      • A price item which stores the pricing arrangement from the ancillary transaction.

    • Characteristics - Used to define the characteristics for the ancillary pricing rule type.

    • Ancillary-Specific Additional Data - Used to define ancillary-specific additional data.
      Note: Following fields are required when you are defining the Ancillary-Specific Additional Data for the ancillary pricing rule type.

      • Billing Eligibility Identifier Value

      • Billing Non-Eligibility Identifier Value

    • Pricing Arrangements - Used to define the pricing arrangements for the ancillary pricing rule type.

      • Pass Through (Markup or Markdown Optional)

      • Pass Through Without Markup or Markdown

      • Rate Based (Markup or Markdown Optional)

    The Main section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Pricing Rule Type Displays the ancillary pricing rule type. Not applicable
    Description Used to specify the description for an ancillary pricing rule type. Yes
    Detailed Description Used to specify additional information about the ancillary pricing rule type. No
    Pricing Rule Business Object Used to indicate the business object using which you want to create an ancillary pricing rule. The valid value is:

    • Aggregate Stop-Loss (ASL) Pricing Rule

    • Ancillary Pricing Rule

    • Claim Pricing Rule

    • Discount Arrangement Pricing Rule

    • Flat Fee Pricing Rule

    • Level Funded (LF) Pricing Rule

    • Retention Type Claim Based Pricing Rule

    • Retention Type Enrollment Based Pricing Rule

    • Specific Stop-Loss (SSL) Pricing Rule

    Note: You must select the Ancillary Pricing Rule option from the Pricing Rule Business Object list while defining an ancillary pricing rule type.
    		 Yes
    Business Object Indicates the ancillary pricing rule type business object using which you are defining the ancillary pricing rule type. Not applicable
    Status Used to indicate the status of the ancillary pricing rule type. The valid values are:

    • Active

    • Inactive

    		 Yes
    Primary Used to indicate whether the ancillary pricing rule type is a primary pricing rule type.
    Note: This field is disabled when you select the Flat Fees option from the Pricing Rule Type Category list.
    		 No
    Pricing Rule Type Category Indicates the category to which the ancillary pricing rule type belongs. The valid values are:

    • Aggregate Stop-Loss

    • Ancillary

    • Claim

    • Discount Arrangement

    • Flat Fees

    • Level Funded

    • Retention Type Claim Based

    • Retention Type Enrollment Based

    • Specific Stop-Loss

    Note: You must select the Ancillary option from the Pricing Rule Type Category list while defining an ancillary pricing rule type.
    		 No
    Tip: Alternatively, you can edit the details of an ancillary pricing rule type by clicking the Edit button in the Pricing Rule Type zone to edit the pricing rule type for ancillary.
  5. Modify the required details in the Main section, if required.
  6. Ensure that the Ancillary Pricing Rule option is selected from the Pricing Rule Business Object list.
  7. Ensure that the Primary option is selected in the Main section.
  8. Add, edit, or remove the related pricing rule types in the ancillary pricing rule type, if required.
    Note: The Related Pricing Rule Types section appears when the Primary option is selected from the Main section.
  9. Modify the transaction field mapping in the ancillary pricing rule type, if required.
    Note: The Transaction Field Mapping section appears when the Primary option is selected from the Main section.
  10. Add, edit, or remove algorithms from the ancillary pricing rule type, if required.
    System Event Algorithm Algorithm Type Description
    Account and Price Item Derivation C1_​ACCPRIDIS C1_​ACCPRIDIS Account and Priceitem Derivation For Discount Arrangement
  11. Edit generic additional data for the ancillary pricing rule type, if required.
  12. Add, edit, or remove price items in an ancillary pricing rule type, if required.
  13. Add, edit, or remove price item parameters in an ancillary pricing rule type, if required.
  14. Add, edit, or remove characteristics in an ancillary pricing rule type, if required.
  15. Modify the ancillary-specific data in an ancillary pricing rule type, if required.
  16. Modify the pricing arrangements in an ancillary pricing rule type, if required.
  17. Click Save.
    The changes made to the ancillary pricing rule type are saved.

Related Topics

For more information on... See...
How to add related pricing rule type in an ancillary pricing rule type Adding a Related Pricing Rule Type in an Ancillary Pricing Rule Type
How to map the transaction fields in an ancillary pricing rule type Mapping the Transaction Field in an Ancillary Pricing Rule Type
How to associate an algorithm with an ancillary pricing rule type Associating an Algorithm with an Ancillary Pricing Rule Type
How to defining additional data in an ancillary pricing rule type Defining Additional Data in an Ancillary Pricing Rule Type
How to adding a price item in an ancillary pricing rule type Adding a Price Item in an Ancillary Pricing Rule Type
How to add a price item parameter in an ancillary pricing rule type Adding a Price Item Parameter in an Ancillary Pricing Rule Type
How to define the ancillary-specific data in an ancillary pricing rule type Defining the Ancillary-Specific Data in an Ancillary Pricing Rule Type
How to define pricing arrangements in an ancillary pricing rule type Defining Pricing Arrangements in an Ancillary Pricing Rule Type