Editing a Claim Pricing Rule of a Bill Group

Prerequisites

To edit a claim pricing rule of a bill group, you should have:

  • Business Object C1-PricingRuleClaim defined for claim pricing rule.

  • Rate options defined in the Rate Option (C1-ExtLookRateType) extendable lookup.

  • Claim template defined in the Claim Template (C1-ExtLookClaimTemplate) extendable lookup.

  • Line items defined in the Line Item (C1-ExtLookPricingRuleLineItem) extendable lookup.

Procedure

To edit a claim pricing rule of a bill group:

  1. Search for the account, person, or policy whose pricing details you want to view in the Customer 360° View screen.
  2. In the Search Results section, click the View (The View Icon) icon corresponding to the account, person, or policy whose pricing details you want to view.
    The Account, Person, or Policy tab in the Customer 360° Information screen appears.
  3. Click the Pricing Information tab.
    The Pricing Information tab appears.
  4. Click the Broadcast (The Broadcast Icon) icon in the Bill Group ASO Policy Information zone, corresponding to the Bill Group Information column, whose bill group details you want to view.
    The Bill Group ASO Policy Pricing Rules zone appears.
  5. Click the Edit (The Edit Icon) icon in the Bill Group ASO Policy Pricing Rules zone, corresponding to the Pricing Group Information column, whose pricing details you want to edit.

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

    • Customer Information - Displays the customer information for the bill group.

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

    • Claim Handling Fees - Used to define the claim handling fees on the lines items in the claim pricing rule.

    • Markup or Markdown Values - Used to define the markup or markdown values on the lines items in the claim pricing rule.

    • Line Items - Used to associate line items eligible for billing.

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

    The Customer Information section contains the following fields:

    Column Name Column Description
    Bill Group Information Displays the bill group name.
    Policy Start Date Displays the date from when the policy is effective.
    Policy End Date Displays the date till when the policy is effective.
    Policy Status Indicates the policy status for the claim pricing rule. The valid values are:

    • In Force/Active

    • Post Runout

    • Runout
    Pricing Rule Type Indicates the pricing rule type.
    Status Indicates the bill group status for the claim pricing rule. The valid values are:

    • Active

    • Inactive

    • Pending

    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 edit the pricing. Yes
    Pricing Start Date Used to specify the start date from when the pricing will be effective for the price item.
    Note: The pricing start date cannot be later than the pricing end date.
    		 Yes (Conditional)
    Note: Pricing Start Date should be entered if Pricing End Date has been mentioned.
    Pricing End Date Used to specify the end date till when the pricing will be effective for the price item.
    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 editing the pricing for the price item. Yes
    Claim Template Used to indicate the claim template of the claim pricing rule for a bill group. Yes
    Note: This section also consists of a button, Reapply, on clicking the button a message occurs indicating that updating the claim template will reset all the default fields on the pricing rule.
  6. Modify the details in the Main section, if required.
  7. Modify the claim handling fees specified on the line items in a claim pricing rule, if required.
  8. Modify the markup or markdown values on the line items in a claim pricing rule, if required.
  9. Modify the line items in a claim pricing rule, if required.
  10. Add, edit, or remove the characteristics for a claim pricing rule, if required.
  11. Click Save.
    The changes made to a claim pricing rule for a bill group are saved.

Related Topics

For more information on... See...
Customer 360° Information - Pricing tab Customer 360° Information - Pricing Information
Bill Group ASO Policy Pricing Rules zone Bill Group Self-Funded Policy Pricing Rules
How to define the claim handling fees for line items in a claim pricing rule Defining the Claim Handling Fees For Line Items in a Claim Pricing Rule
How to define the markup or markdown values for line items in a claim pricing rule Defining the Markup or Markdown Values For Line Items in a Claim Pricing Rule
How to define a characteristic for a claim pricing rule Defining a Characteristic for a Claim Pricing Rule