Defining a Billing Preference

Prerequisites

To define a billing preference, you should have:

  • Field mapping business objects defined in the application.

  • Bill cycles and bill periods defined in the application.

Procedure

To define a billing 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 a billing preference. The valid values are:

    • Bill Route Method - Contact Method Mapping (i.e., C1_​​BillRouteCntMethMap) - Enables you to maintain a routing method - contact method mapping preference.

    • Field Mapping (i.e., C1-FieldMapping) - Enables you to maintain the following:

      • Automatic Refund/Write-Off Preference

      • Billing Preference

      • Binder Payment Preference

      • Configuration for Match Type - Handling Overpayment Preference

      • Delinquency Process Preference

      • Delinquency Process Type Preference

      • Geographic Rating Area Preference

      • Individual Membership Preference

      • Medicare Preference

      • Member Reconciliation Preference

      • Member Relationship and Subscription Tier Preference

      • Membership Repricing Reasons Preference

      • Statement Construct Preference

    • Group Membership Status Reason Mapping (i.e., C1-MemStatusReasonMapGroup) - Enables you to maintain a group membership status reason preference.

    • Medicare Plan Benefit Package (i.e., C1-BenefitPackage) - Enables you to maintain a Medicare plan benefit package.

    • Membership Status Reason Mapping (i.e., C1-MemStatusReasonMapping) - Enables you to maintain an individual membership status reason preference.

    Note: The above business objects are shipped with the product. The list includes those business objects which are created using the Field Mapping (i.e., C1-FIELDMAP) maintenance object.
    		 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 for the billing preference. It contains the following fields:

      Field Name Field Description Mandatory (Yes or No)
      Preference Used to specify the billing preference. Yes
      Description Used to specify the description for the billing preference. Yes
      Detailed Description Used to specify additional information about the billing preference.
      Note: You can resize the text box depending on your requirement by clicking the Resize Handle (The Resize Handle Icon) icon at the bottom right corner of the text box.
      		 No
      Status Used to indicate the status of the billing preference. The valid values are:

      • Active

      • Inactive

      		 Yes

    • Preference Category - Used to specify the preference category. It 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

      • Configuration for Match Type - Handling Overpayment

      • Delinquency Process

      • Delinquency Process Type

      • Geographic Rating Area

      • Individual Membership

      • Medicare

      • Medicare Plan Benefit

      • Member Reconciliation

      • Member Relationship and Subscription Tier

      • Membership Repricing Reasons

      • Membership Status Reason

      • Routing Method - Contact Method Mapping

      • Statement Construct

      Note:

      The list includes only those values which are defined in the FIELD_​CAT_​FLG lookup field.

      You must select the Billing option from the list while creating a billing preference.

      		 Yes

    • Preference Settings - Used to set the attributes in the billing preference. It contains the following fields:

      Field Name Field Description Mandatory (Yes or No)
      Attribute Used to indicate the attribute that you want to set in the billing preference.
      Note: The attribute list appears only when the preference category is selected from the respective list.
      		 Yes
      Value Used to specify the attribute value.
      Note:

      The attribute value list appears only when the attribute is selected from the respective list.

      The attribute value list varies depending on the attribute that you want to set in the billing preference.

      		 Yes
      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 in the MAP_​ENTITY_​FLG lookup field.
      		 No

      The following table lists and describes the attributes available while defining, editing, or copying the billing preference:

      Attribute Description Mandatory (Yes or No)
      Bill Cycle Used to specify the bill cycle. The system derives the bill cycle for an account from the billing preference when the billing preference characteristic is specified while creating or editing the account from the user interface or through a health care inbound message.
      Note: The list includes only those bill cycles which are already defined in the system.
      		 Yes (Conditional)
      Note: This data is required when you want to derive the bill cycle for an account from the billing preference.
      Bill Period Used to specify the bill period. The system derives the bill period for an account from the billing preference while creating billable charges for the account when:

      • The billing preference characteristic is defined for the account.

      • The C1-BILLPDRV algorithm is invoked from the age based, tier based, additional fee, benefit, and/or discount charge pricing rule types.

      Note: The list includes only those bill periods which are already defined in the system.
      		 Yes (Conditional)
      Note: This data is required when you want to derive the bill period for an account from the billing preference.
      Skip Months Used to specify the month for which you want to skip billing for the account. The valid values are:

      • January

      • February

      • March

      • April

      • May

      • June

      • July

      • August

      • September

      • October

      • November

      • December

      Note: You can define this attribute multiple times in the billing preference when you want to skip more than one month for billing. The skip months can be continuous or noncontinuous. However, note that, you cannot skip all 12 months in the billing preference.
      		 Yes (Conditional)
      Note: This data is required when you want to use the 9/10 Billing (Skip Months) feature for an account.
      Note: While defining a billing preference, you must set at least one attribute in the billing preference.
  6. Select the Billing option from the Preference Category list.
    The Preference Category section disappears and the Preference Category field appears in the Main section.
  7. Enter the required details in the Main section.
  8. Set the required attributes in the billing preference.
  9. If you want to set more than one attribute in the billing preference, click the Add (The Add Icon) icon and then repeat step 8.
    Note: However, if you want to remove an attribute from the billing preference, click the Delete (The Delete Icon) icon corresponding to the attribute.
  10. Click Save.
    The billing preference is defined.

Related Topics

For more information on... See...
Field Mapping screen Field Mapping
Tightly Coupled Bill Cycle and Bill Period through Billing Preference Tightly Coupled Bill Cycle and Bill Period through Billing Preference
9/10 Billing (Skip Months) 9/10 Billing (Skip Months)