Delinquency Grace Period Business Rule

Oracle Revenue Management and Billing enables you to define business rules for determining the grace period during the delinquency management. The insurance company may offer different grace period to different individuals 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 grace period to calculate the following:

  • Trigger dates for the delinquency events

  • Termination request date when you want to send the outbound message to the external system requesting to terminate the individual membership

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

While defining the delinquency grace period 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 grace period business rule through the Business Rule screen. While defining a delinquency grace period business rule, you need to set its category to Delinquency Grace Period 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 grace 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.

  • Grace Period (Days) - Used to specify the grace period in days.

You can view the delinquency grace period business rules through the Business Rule screen.

Parent topic: Business Rules