Delinquency Events Attribute Business Rule

Oracle Revenue Management and Billing enables you to define business rules for determining the waiting time (in days or months) before triggering a delinquency event in the delinquency process. The insurance company may offer different waiting time for different delinquency event types (such as sending letters, sending To Do notification, or initiating the termination request) based on certain parameters, such as division, customer class, region, and jurisdiction in which the individual customer has availed for the health plan coverage. The system will then accordingly use the wait days or the wait months and the day of month (depending on the wait period that is configured) to calculate the trigger dates for the delinquency events.

The system considers the delinquency event attributes business rules to determine the wait period only when the wait period source is set to Algorithm in the respective delinquency process type. If the wait period source is set to Algorithm, the system executes the C1-DERWDBR algorithm attached to the Wait Days Derivation system event of the delinquency process type when you execute the C1-DPMON batch. For more information on how the wait period is derived, refer to the respective algorithm description in the Delinquency Process Type Algorithms section.

While defining the delinquency event attributes business rule criteria, you can use the parameters which are defined on the following entities:

  • Account

  • Customer Class

  • Delinquency Event Type

  • Division

  • Health Plan

  • Health Product

  • Membership

  • Membership Person

  • Policy

  • Policy Plan

You can define, edit, and delete a delinquency event attributes business rule through the Business Rule screen. While defining a delinquency event attributes business rule, you need to set its category to Delinquency Event Attributes Business Rule and specify the following details:

  • Criteria Description - Used to indicate the business criteria that an individual membership must satisfy in order to derive the wait period from the business rule.

  • Effective Date - Used to specify the date from when the business rule is effective.

  • Status - Used to indicate the status of the business rule. The valid values are Active and Inactive.

  • Wait Days - Used to indicate the number of days for which you want to delay a delinquency event in a delinquency process.

  • Wait Month - Used to indicate the number of months for which you want to delay a delinquency event in a delinquency process.

  • Wait Day of Month - Used to indicate the day of the month when you want to trigger a delinquency event of a delinquency process.

  • Send Membership Level Notification - This parameter is not applicable for the fully insured individual business.

You can view the delinquency event attributes business rules through the Business Rule screen.

Parent topic: Business Rules