Bill Groups

The system allows you to define one or more bill groups for a parent customer. The claim, enrollment, and ancillary transactions of the employees are billed to a bill group. Each bill group will handle the claim, enrollment, and ancillary transactions of employees based on the employee attributes, such as location, employment status, employment department, and so on. The system allows you to define the derivation and pricing parameters, such as source system, parameter 1, parameter 2, parameter 3, and parameter 4 for a bill group. These parameters are used to derive the bill group against which the claim, enrollment, and ancillary charges should be billed in the system. The derived bill group is also used for billing the claim based fees, specific stop-loss credits, aggregate stop-loss credits, discount, and level funding charges.

You can define a person as the bill group by setting its person type to Bill Group. The bill groups should be defined as the child persons of the parent customer (i.e. self-funded employer) using the relationship type which is specified in the Person Relationship Type option type of the C1-ASOBLLNG feature configuration. You can create a bill group through a customer registration object or a health care inbound message.

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