Refund/Write Off Business Rules

Oracle Revenue Management and Billing enables you to define business rules for automatic refund and write off creation. A new category named Refund/Write Off Business Rule is introduced in this release. The refund/write off business rules are used for creating automatic refund and write off requests for accounts when the fully-insured group policy or individual membership is terminated.

While terminating a fully-insured group policy or individual membership, the system derives the refund/write off business rule for the fully-insured group policy or individual membership. While deriving the refund/write off business rule for a fully-insured group policy or individual membership, the system considers the business rules which are effective on the termination date. Once the effective business rules are identified, the system executes these business rules in the order of their priority. Once the criteria of the business rule are met, the business rule is stamped against the fully-insured group policy or individual membership. If two or more business rules have the same priority, the system sorts the business rules for execution based the business rule criteria sequence.

While defining the refund/write off business rule criteria, you can use the parameters which are defined on the following entities:

  • Individual Membership

  • Member Person of Individual Membership

  • Health Plan

  • Health Product

  • Policy

  • Account

You can define, edit, and delete a refund/write off business rule through the Business Rule screen. While defining a refund/write off business rule, you need to set its category to Refund/Write Off Business Rule. The refund/write off business rule enables you to define the following parameters:

  • Refund Threshold Amount - Used to specify the threshold amount for refund. If the account balance is greater than or equal to the refund threshold amount, the system creates automatic refund for an account.

  • Defer Refund (in Days) - Used to specify the number of days till when you want to defer the automatic refund for an account. It is used while calculating the automatic refund request creation date.

  • Write Off Threshold Amount - Used to specify the threshold amount for write off. If the account balance is less than or equal to the write off threshold amount, the system creates automatic write off for an account.

  • Defer Write Off (in Days) - Used to specify the number of days till when you want to defer the automatic write off for an account. It is used while calculating the automatic write off request creation date.

You can view the refund/write off business rules through the Business Rule screen.

Parent topic: Business Rules