Delinquency Process Type

Once you create the delinquency event types, you need to create the required delinquency process types using which you want the system to create a delinquency process for a person or an account. You can design various delinquency process types that trigger different types of events for the different types of insurance coverages. For example, you can define different delinquency process types for the following:

  • Active health plan coverages

  • Inactive health plan coverages

  • Medical health plan coverages with benefits

  • Medical health plan coverages without benefits

  • Non-medical health plan coverages

  • Non-effectuated health plan coverages

You can then configure the delinquency process type for each type of insurance coverage through the delinquency process type preference. For more information, see Delinquency Process Types Based on Insurance Coverage. The system considers the delinquency process type preference which is specified in the C1-DLNQMNRL algorithm attached to the respective delinquency control. Depending on the following line of business, the system considers the delinquency process type preference specified in the respective parameter of the C1-DLNQMNRL algorithm:

Line of Business Algorithm Parameter
Fully Insured Group Delinquency Process Type Field Mapping – Group
Fully Insured Individual Delinquency Process Type Field Mapping – Individual
Group Direct Billed Membership Delinquency Process Type Field Mapping – Individual

A new maintenance object named C1-DLQ-PRC-T and a new business object named C1-DelinProcType are introduced to create the delinquency process types. The Delinquency Process Type screen enables you to create, edit, delete, and copy a delinquency process type. While creating a delinquency process type, you can specify the following:

  • Basic details for the delinquency process type

  • Details for the delinquency event trigger date calculation

  • Types of delinquency events that you want to trigger in a delinquency process which is created using the delinquency process type

  • Algorithms that you want to attach to the delinquency process type

  • Details for the grace period calculation

  • Details for the termination request (outbound message) trigger process

  • Details for the termination date calculation

  • Priority for each termination date rule

  • Details for the trigger date recalculation when a delinquency process which is on hold is released and when a delinquency process which is canceled is resumed

  • Actions for which you want to configure the approval process