Defining an Overpayment Handling through a Match Type Preference

Prerequisites

To define an overpayment handling through a match type preference, you should have:

  • Value defined for the Field Mapping for Match Type option type in the C1-PAYFLUPLD feature configuration.

  • Values defined in the FIELD_​CAT_​FLG, FIELD_​STATUS_​FLG, and FIELD_​NAME_​FLG lookup field.

  • Values defined in the PAY_​TND_​STG_​ST_​FLG lookup field.

Procedure

To define an overpayment handling through a match type preference:

  1. Click the Admin link in the Application toolbar.
    A list appears.
  2. From the Admin menu, select F and then click Field Mapping.
    A sub-menu appears.
  3. Click the Add option from the Field Mapping sub-menu.

    The Select Business Object screen appears. It contains the following field:

    Field Name Field Description Mandatory (Yes or No)
    Field Mapping Business Object Used to indicate the business object using which you want to create an overpayment handling through a match type preference. The valid values are:

    • Field Mapping

    • Medicare Plan Benefit Package

    • Membership Status Reason Mapping

    		 Yes
    Note: Alternatively, you can access the Select Business Object screen by clicking the Add button in the Page Title area of the Field Mapping screen.
  4. Select the Field Mapping option from the Field Mapping Business Object list.
  5. Click OK.

    The Field Mapping screen appears. It contains the following sections:

    • Main - Used to specify basic details of the overpayment handling through a match type preference. It contains the following fields:

      Field Name Field Description Mandatory (Yes or No)
      Preference Used to specify the overpayment handling through a match type preference. Yes
      Description Used to specify the description for the overpayment handling through a match type preference. Yes
      Detailed Description Used to specify additional information about the overpayment handling through a match type preference. No
      Status Used to indicate the status of the overpayment handling through a match type preference. The valid values are:

      • Active

      • Inactive

      		 Yes

    • Preference Category - This section contains the following field:

      Field Name Field Description Mandatory (Yes or No)
      Preference Category Used to indicate the category to which the preference belongs. The valid values are:

      • Automatic Refund/Write Off

      • Billing

      • Binder Payment

      • Handling Overpayment through a Match Type

      • Geographic Rating Area

      • Individual Membership

      • Medicare

      • Medicare Plan Benefit

      • Member Reconciliation

      • Member Relationship and Subscription Tier

      • Member Status Reason Preferences

      • Statement Construct

      Note: You must select Handling Overpayment through a Match Type option as the preference category while creating an overpayment handling through a match type.
      		 Yes

    • Preference Settings - Used to set the attributes in the overpayment handling through a match type preference.

      Field Name Field Description Mandatory (Yes or No)
      Attribute Used to indicate the attribute which you want to set in the overpayment handling through a match type preference. The valid values are:

      • Match Type for On Account Payment (C) - At present, there is no functionality built using this attribute. It would be used in the future release of ORMB.

      • Match Type for Default Payment Distribution (D) - Used to indicate the match types for which the system should behave in the following manner:
        PUPL Batch Run Then...
        First
        The system does the following:

        • Processes the first payment record of each payee account and changes the status of the corresponding payment tender staging records to Pending.

        • Does not process the subsequent payment records of each payee account and changes the payment tender staging record status of the subsequent payment records to Ignored.

        Note: Once the three-step PUPL batch cycle is completed, the status of the payment record is changed to Processed or Error in Staging depending on whether it is successfully processed or not. In addition, the status of the corresponding payment tender staging records is changed from Pending to Complete.
      		Yes (Conditional)
      Note: This field is required while defining the settings for an overpayment handling through a match type preference.
      PUPL Batch Run Then...
      Second
      The system does the following:

      • Processes the second payment record of each payee account and changes the status of the corresponding payment tender staging records from Ignored to Pending.

      • Does not process the subsequent payment records of each payee account and the payment tender staging record status of the subsequent payment records remains as Ignored.

      Note: Once the three-step PUPL batch cycle is completed, the status of the payment record is changed to Processed or Error in Staging depending on whether it is successfully processed or not. In addition, the status of the corresponding payment tender staging records is changed from Pending to Complete.
      Note: In each three-step PUPL batch cycle, the system considers and processes one payment record of a payee account at a time and therefore you need to repeat the three-step PUPL batch cycle until all payment records of the payee account are processed.
      • Match Type for Overpayment Distribution (O) - Used to indicate the match types for which the system should behave in the following manner:
        PUPL Batch Run Then...
        First
        The system does the following:

        • Processes the first payment record of each payee account and match value combination and changes the status of the corresponding payment tender staging records to Pending.

        • Does not process the subsequent payment records of each payee account and match value combination and changes the payment tender staging record status of the subsequent payment records to Ignored.

        Note: Once the three-step PUPL batch cycle is completed, the status of the payment record is changed to Processed or Error in Staging depending on whether it is successfully processed or not. In addition, the status of the corresponding payment tender staging records is changed from Pending to Complete.
      PUPL Batch Run Then...
      Second
      The system does the following:

      • Processes the second payment record of each payee account and match value combination and changes the status of the corresponding payment tender staging records from Ignored to Pending.

      • Does not process the subsequent payment records of each payee account and match value combination and the payment tender staging record status of the subsequent payment records remains as Ignored.

      Note: Once the three-step PUPL batch cycle is completed, the status of the payment record is changed to Processed or Error in Staging depending on whether it is successfully processed or not. In addition, the status of the corresponding payment tender staging records is changed from Pending to Complete.
      Note: In each three-step PUPL batch cycle, the system considers and processes one payment record of each payee account and match value combination at a time and therefore you need to repeat the three-step PUPL batch cycle until all payment records of each payee account and match value combination are processed.
      • Match Type for Segment Level Overpayment Distribution (R) - Used to indicate the match types for which the system should behave in the following manner:
        PUPL Batch Run Then...
        First
        The system does the following:

        • Processes all payment records of the same or different payee account with the same or different match value and changes the status of the corresponding payment tender staging records to Pending.

        Note: Once the three-step PUPL batch cycle is completed, the status of the payment record is changed to Processed or Error in Staging depending on whether it is successfully processed or not. In addition, the status of the corresponding payment tender staging records is changed from Pending to Complete.
      Note:

      You can specify maximum of 20 match types separated by a comma (,) symbol for the above attributes in the field mapping.

      Now, while executing the step-three PUPL batch, the system considers the field mapping which is specified in the Field Mapping for Match Type option type of the C1-PAYFLUPLD feature configuration whenever there are multiple payment records of the payee account in the CSV file. In the following scenarios, the system behaves in the manner as if the match type is set to the Match Type Default Payment Distribution (D) attribute:

      • The value for the Field Mapping for Match Type option type is not defined in the C1-PAYFLUPLD feature configuration

      • The value specified for the Field Mapping for Match Type option type in the C1-PAYFLUPLD feature configuration is invalid

      • The match type received in the payment record is not specified against any of the attribute in the referred field mapping

      To implement this change, a new status named Ignored is added in the PAY_​TND_​STG_​ST_​FLG lookup field.
      Value Used to specify the attribute value. Yes (Conditional)
      Note: This field is required while defining the settings for an overpayment handling through a match type preference.
      Entity Type Used to indicate the type of entity for which the attribute is applicable. The valid values are:

      • Account

      • Adjustment

      • Billable Charge

      • Membership

      • Payment

      • Policy

      Note: At present, this data is stored for informational purposes only and is not considered in the business logic. If required, you can add more entity types to the MAP_​ENTITY_​FLG lookup field.
      		 No
      Note: While defining an overpayment handling through a match type preference, you must set at least one attribute in the overpayment handling through a match type preference.
  6. Select the Handling Overpayment through Match Type option from the Preference Category list.
  7. Enter the required details in the Main section.
  8. Select the required attribute and value from the respective fields.
  9. If you want to set more than one attribute in the overpayment handling through a match type preference, click the Add (The Add Icon) icon and then repeat step 8.
    Note: However, if you want to remove an attribute from the overpayment handling through a match type preference, click the Delete (The Delete Icon) icon corresponding to the attribute.
  10. Click Save.
    The overpayment handling through a match type preference is defined.

Related Topics

For more information on... See...
Field Mapping screen Field Mapping