Delinquency Grace Period Business Rule

Oracle Revenue Management and Billing enables you to define business rules to determine the grace period while monitoring delinquency at the person or account level. The insurance company may offer different grace period for different policies, direct billed group memberships, or individual memberships based on their attributes, such as health or policy plan, division, policy or membership characteristic, etc. 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 fully insured group policy, direct billed group membership, or individual membership, respectively.

While executing the C1-DPEVL batch, the system derives the business rules with the Delinquency Grace Period Business Rule category that are effective on the batch business date. Note that the system considers only those effective business rules which are in the Active status. The system then executes the criteria of each effective business rule and considers the business rule that meet the criteria. If two or more business rules meet the criteria, the system considers the business rule with the highest priority.

The system stamps the delinquency grace period business rule against the fully insured group policy, direct billed group membership, or individual membership, respectively, in the C1_​ENT_​BUS_​RULE table. The system derives the grace details for the delinquency process from the business rule. The system derives the grace period for each active policy billed to the delinquent person or account. Similarly, the system derives the grace period for each active direct billed group membership or individual membership billed to the delinquent account. Among the grace period derived for different policies or memberships, the system considers the grace period of the policy or membership with maximum grace limit and calculates the grace end date for the delinquency process using the maximum grace limit.

Note: 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. For more information about the algorithm, see C1-DERGRBR.

While defining criteria for a delinquency grace period business rule, you can use parameters that are defined on the following source entities:

  • Account

  • Customer Class

  • Delinquency Event Type

  • Division

  • Health Plan

  • Health Product

  • Membership

  • Membership Person

  • Policy

  • Policy Plan

  • Algorithm

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 the category to Delinquency Grace Period Business Rule. The delinquency grace period business rule enables you to define the following parameter:

  • Grace Period Type - Used to indicate whether the grace period is in days or months.

  • Grace Period - Used to specify the number of days or months.

You can use the same criteria in multiple business rules to derive different grace details but with different effective date. You can view the delinquency grace period business rules through the Business Rule screen.

Parent topic: Business Rules