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Oracle Revenue Management and Billing
Oracle Revenue Management and Billing
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  3. Business Processes
  4. Oracle Revenue Management and Billing Insurance Business Processes
  5. Self-Funded Billing
  6. Self-Funded Billing Process
  • Oracle Revenue Management and Billing
    • Business Processes
      • Oracle Utilities Application Framework Business Processes
      • Oracle Revenue Management and Billing Generic Business Processes
      • Oracle Revenue Management and Billing Financial Services Business Processes
      • Oracle Revenue Management and Billing Insurance Business Processes
        • Leveraging User Experience Features
        • Fully-Insured Group Customer Management
        • Self-Funded Customer Management
        • Health Insurance Business Management
        • Fully-Insured Group Health Insurance
        • Self-Funded Group Health Insurance
        • Individual Health Insurance
        • Customer Registration
        • Customer 360° View
        • Health Product 360° View
        • Pricing Management
        • Inbound Message
        • Invoice Request for Health Insurance Business
        • Upload Lockbox Payment and Remittance Advices
        • Reconciliation
        • Self-Funded Pricing
        • Stop-Loss
        • Self-Funded Billing
          • Pre-requisites
          • Bill Group Derivation and Pricing Parameters
          • Related Pricing Rule Type Eligibility
          • Price Item Eligibility
          • Self-Funded Billing Process
            • Transaction Aggregation
            • Stop Loss Calculation
            • Bill Generation
          • Bill Group Derivation
          • Account and Price Item Derivation (for the Claim Pricing Rule Type Category)
          • Account and Price Item Derivation (for the Specific Stop-Loss and Aggregate Stop-Loss Pricing Rule Type Categories)
          • Account and Price Item Derivation (for the Retention Type Claim Based Pricing Rule Type Category)
          • Account and Price Item Derivation (for the Retention Type Enrollment Based Pricing Rule Type Category)
          • Account and Price Item Derivation (for the Ancillary Pricing Rule Type Category)
          • Bill After Date Determination
          • Advance Billing for Claim Fund Charge
          • SSL Accumulation across Bill Groups
        • Fully-Insured Pricing
        • Fully-Insured Billing
        • Off-Process Request
        • Individual Health Insurance Pricing
        • Individual Health Insurance Billing
        • Automatic Refund
        • Payment Distribution
        • Mass Payment Transfer
        • Reporting
        • Automatic Refund/Write Off
        • Delinquency Management
    • Administrative Processes

Self-Funded Billing Process

The Self-Funded Billing process consists of the following sub-processes:

  • Transaction Aggregation

  • Stop Loss Calculation

  • Bill Generation

Parent Topic: Self-Funded Billing

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