Scenario D
This scenario how the financial message generation process groups financial transactions. The following grouping options exist:
- Financial Message Bulking Group
-
To group the financial transactions into a financial message
- Invoice Bulking Group
-
To group the financial transaction details into invoices within a financial message
- Invoice Line Bulking Group
-
To group the financial transaction details into invoices lines within an invoice
- Accounting Detail Bulking Group
-
To group the financial transaction details into accounting details within an invoice for the invoiced financial transactions or within a financial message for the non invoiced financial transactions
Example 1: Grouping set at various levels
In this scenario we want a separate financial message for every combination of group account and input calculation period. Within the financial message we want a separate invoice for every member and within each invoice we separate invoice lines and accounting details for premium, adjustment and surcharge.
In this scenario we will calculate for two policies, POL1004 and POL1005. POL1005 differs from POL1004 in the way that for POL1005 a regional tax applies and that POl1005 has a collection frequency 2, meaning the system will calculate two calculation periods instead of the 1 calculation period for POL1004.
Policy 1004
Policy 1004 has the following properties:
- Policy Code
-
POL1004
- Group Account
-
ORCL
- Collection Frequency
-
1
- Member
-
2110114 (lives in a state where no regional tax applies)
- Enrollment Product
-
BASIC PLAN with start date 01-Jan-2015
- Add-on
-
Preventive Care with start date 01-Jan-2015
Suppose for the policy POL1004 the following calculation results and financial data exist:
Calculation Result
Calculation Result
| Policy Code | Policy Version | Calculation Result Version | Calculation Period | Total Base Premium | Total Adjustment | Total Surcharge | Total Result |
|---|---|---|---|---|---|---|---|
POL1004 |
1 |
1 |
Jan'15 |
110.00 |
-5.00 |
1.25 |
106.25 |
Calculation Result Lines
| Calculation Result | Version | Seq. | Input Amount | % | Prorate Factor | Result Amount | Add-on | Schedule Definition |
|---|---|---|---|---|---|---|---|---|
Jan'15 |
1 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
- |
- |
- |
-5.00 |
Office Visit Co-payment |
|||
4 |
- |
- |
- |
1.25 |
Surcharge |
Financial Data
Base Financial Object
| Calculation Period Start Date | Policy GID | Status |
|---|---|---|
01-Jan-2015 |
1004 |
Supersede and Reversal Done |
Financial Transaction
Calculation Period Start Date |
Version |
Reversal? |
Financial Transaction Set |
Financial Message Mandatory? |
Superseded? |
Financial Message Handled Datetime |
Financial Message Result |
01-Jan-2015 |
1 |
N |
Premium Calculation Jan'15 |
The Financial Transaction Details corresponding to the financial transactions of the Base Financial Object for the calculation period Jan'15 are as follows:
| Version | Reversal | Component Code | Member Code | Product Code | Amount | Invoice Indicator | Invoice Line Grouping Indicator | Invoice Bulking Group | Invoice Line Bulking Group | Accounting Detail Grouping Indicator | Accounting Detail Bulking Group |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 |
N |
BASIC PLAN |
2110114 |
BASIC PLAN |
105.00 |
Y |
Y |
2110114 |
Premium |
Y |
Premium |
Preventive Care |
2110114 |
BASIC PLAN |
5.00 |
Y |
Y |
2110114 |
Premium |
Y |
Premium |
||
Office VisitCo-payment |
2110114 |
BASIC PLAN |
-5.00 |
Y |
Y |
2110114 |
Adjustment |
Y |
Adjustment |
||
Surcharge |
2110114 |
BASIC PLAN |
1.25 |
Y |
Y |
2110114 |
Surcharge |
Y |
Surcharge |
Policy 1005
Policy 1005 has the following properties:
- Policy Code
-
POL1005
- Group Account
-
ORCL
- Collection Frequency
-
2 [1]
- Member
-
2110115 (lives in a state where regional tax applies)
- Enrollment Product
-
BASIC PLAN with start date 01-Jan-2015
- Add-on
-
Preventive Care with start date 01-Jan-2015
For the policy POL1005 the following calculation results and financial data exist.
Calculation Result
Calculation Result
| Policy Code | Policy Version | Calculation Result Version | Calculation Period | Total Base Premium | Total Adjustment | Total Surcharge | Total Result |
|---|---|---|---|---|---|---|---|
POL1005 |
1 |
1 |
Jan'15 |
110.00 |
-5.00 |
4.00 |
109.00 |
POL1005 |
1 |
1 |
Feb'15 |
110.00 |
-5.00 |
4.00 |
109.00 |
Calculation Result Lines
| Calculation Result | Version | Seq. | Input Amount. | % | Prorate Factor | Result Amount | Add-on | Schedule Definition |
|---|---|---|---|---|---|---|---|---|
Jan'15 |
1 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
110.00 |
2.5 |
- |
2.75 |
Regional Tax |
|||
4 |
- |
- |
- |
-5.00 |
Office Visit Co-payment |
|||
5 |
- |
- |
- |
1.25 |
Surcharge |
|||
Feb'15 |
1 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
110.00 |
2.5 |
- |
2.75 |
Regional Tax |
|||
4 |
- |
- |
- |
-5.00 |
Office Visit Co-payment |
|||
5 |
- |
- |
- |
1.25 |
Surcharge |
Financial Data
Base Financial Object
| Calculation Period Start Date | Policy | Status |
|---|---|---|
01-Jan-2015 |
1005 |
Supersede and Reversal Done |
01-Feb-2015 |
1005 |
Supersede and Reversal Done |
Financial Transaction
| Calculation Period Start Date | Version | Reversal? | Financial Transaction Set | Financial Message Bulking Group | Financial Message Mandatory? | Financial Message Handled Datetime | Financial Message Result |
|---|---|---|---|---|---|---|---|
01-Jan-2015 |
1 |
N |
Premium Calculation Jan'15 |
ORCL-Jan'15 |
|||
01-Feb-2015 |
1 |
N |
Premium Calculation Jan'15 |
ORCL-Jan'15 |
The Financial Transaction Details corresponding to the financial transactions of the Base Financial Object for the calculation period Jan'15 are as follows:
| Version | Reversal | Component Code | Member Code | Product Code | Amount | Invoice Indicator | Invoice Line Grouping Indicator | Invoice Bulking Group | Invoice Line Bulking Group | Accounting Detail Grouping Indicator | Accounting Detail Grouping Indicator |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 |
N |
BASIC PLAN |
2110115 |
BASIC PLAN |
105.00 |
Y |
Y |
2110115 |
Premium |
Y |
Premium |
Preventive Care |
2110115 |
BASIC PLAN |
5.00 |
Y |
Y |
2110115 |
Premium |
Y |
Premium |
||
Regional Tax |
2110115 |
BASIC PLAN |
2.75 |
Y |
Y |
2110115 |
Surcharge |
Y |
Surcharge |
||
Office VisitCo-payment |
2110115 |
BASIC PLAN |
-5.00 |
Y |
Y |
2110115 |
Adjustment |
Y |
Adjustment |
||
Surcharge |
2110113 |
BASIC PLAN |
1.25 |
Y |
Y |
2110115 |
Surcharge |
Y |
Surcharge |
Similar Financial Transaction Details are created for the financial transactions corresponding to the Base Financial Object for the calculation period Feb'15
Financial Processing
The financial message generation activity groups the financial transactions based on the financial message bulking group when specified, otherwise it groups the financial transactions based on the policy into a financial message. Here, the combination of the group account code and input calculation period is specified as the financial message bulking group and, therefore, the financial transaction of the policy POL1004 and POL1005 with the same value of financial message bulking group are grouped together into one message.
The contents of the various parts of the financial message are as follows
Financial Message
Financial Message
| Job ID | Message Date | Message Bulking Group |
|---|---|---|
132534 |
01-Jan-2015 |
ORCL-Jan'15 |
Financial Message - Invoice
The number of invoices to be created is driven by
-
The financial transactions with the field Financial Message Mandatory Indicator set to 'Y' (see Scenario C).
-
The Invoice Bulking Group.
Here, the invoice bulking group is set to the member code and, therefore, two invoices are created.
| ID | Invoice Type | Invoice Amount |
|---|---|---|
89075 |
Standard |
106.25 |
89076 |
Standard |
218.00 |
Financial Message - Invoice Line
The invoice line grouping indicator on the Financial Transaction Detail Process Data is set to 'Y', therefore, the system groups multiple Financial Transaction Details of each invoice into a single invoice line. The following attributes are used for grouping:
-
Invoice Line Bulking Group (from Financial Transaction Detail Process Data)
-
In this scenario, the invoice lines are grouped based on being a premium, a surcharge or an adjustment
-
-
Reversal Indicator (from Financial Transaction)
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89075 |
123615 |
1 |
ITEM |
110.00 |
89075 |
123616 |
2 |
ITEM |
1.25 |
89075 |
123617 |
3 |
ITEM |
-5.00 |
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89076 |
123618 |
1 |
ITEM |
220.00 |
89076 |
123619 |
2 |
ITEM |
8.00 |
89076 |
123620 |
3 |
ITEM |
-10.00 |
Financial Message - Accounting Details
The financial transactions are grouped to create accounting details because the accounting detail grouping indicator is set to 'Y'. The grouping criteria are * General Ledger Account (from Financial Transaction Detail Process Data) ** Suppose the ledger account 32423430 is used to account for the surcharge amounts, 32423431 is used for the adjustments and 32423432 for the premiums. * Accounting Bulking Group (from Financial Transaction Detail Process Data)
-
Reversal Indicator (from Financial Transaction)
Accounting Details - Invoice Id 89075
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719064 |
32423432 |
01-Jan-2015 |
110.00 |
8719065 |
32423430 |
01-Jan-2015 |
1.25 |
8719066 |
32423431 |
01-Jan-2015 |
-5.00 |
Accounting Details - Invoice Id 89076
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719067 |
32423432 |
01-Jan-2015 |
220.00 |
8719068 |
32423430 |
01-Jan-2015 |
8.00 |
8719069 |
32423431 |
01-Jan-2015 |
-10.00 |
Once the financial message is created, the Financial Transaction Detail Process Data is updated with the details of the invoice id, invoice line id and accounting detail id. The financial message result and financial message handled date time on Financial Transaction Process Data are also updated.
Situation 2: Grouping when the Financial Message Mandatory Indicator is set to 'Y'
The financial transaction details that belong to the financial transaction with the message mandatory indicator set to 'Y' always become part of separate invoices. These financial transaction details in the context of the mandatory invoice could be grouped among themselves but are never grouped with the financial transaction details of any other financial transactions to create an invoice.
| This situation looks like the one described in Scenario C. However, scenario C does not include the specification of grouping on the invoice line. This scenario does. |
Suppose the following financial data exist for the policy POL1006.
In this scenario we don’t explicitly set the Financial Message Bulking Group, and therefore the financial transactions are grouped in separate financial messages as per the policy. We set the invoice bulking group to the calculation period. We set the invoice line grouping indicator to 'Y', however we do not specify the invoice line bulking group. In this case the Financial Transaction Details are grouped into invoice lines as per the default criteria: the Reversal Indicator (from Financial Transaction).
Financial Data
Base Financial Object
| Calculation Period Start Date | Policy | Status |
|---|---|---|
01-Jan-2015 |
1006 |
Supersede and Reversal Done |
01-Feb-2015 |
1006 |
Supersede and Reversal Done |
Financial Transaction
| Calculation Period Start Date | Version | Reversal? | Financial Transaction Set | Financial Message Mandatory? | Superseded? | Financial Message Handled Datetime | Financial Message Result |
|---|---|---|---|---|---|---|---|
01-Jan-2015 |
1 |
N |
Y |
||||
01-Jan-2015 |
1 |
Y |
|||||
01-Jan-2015 |
3 |
N |
|||||
01-Feb-2015 |
1 |
N |
Y |
||||
01-Feb-2015 |
1 |
Y |
|||||
01-Feb-2015 |
3 |
N |
The Financial Transaction Details corresponding to the financial transactions of the Base Financial Object for the calculation period Jan'15 are as follows:
| Version | Reversal | Component Code | Member Code | Product Code | Amount | Invoice Indicator | Invoice Line Grouping Indicator | Invoice Bulking Group | Invoice Line Bulking Group | Accounting Detail Grouping Indicator |
|---|---|---|---|---|---|---|---|---|---|---|
1 |
N |
BASIC PLAN |
2110116 |
BASIC PLAN |
105.00 |
Y |
Y |
Jan'15 |
N |
|
Preventive Care |
2110116 |
BASIC PLAN |
5.00 |
Y |
Y |
Jan'15 |
N |
|||
Regional Tax |
2110116 |
BASIC PLAN |
2.75 |
Y |
Y |
Jan'15 |
N |
|||
Office VisitCo-payment |
2110116 |
BASIC PLAN |
-5.00 |
Y |
Y |
Jan'15 |
N |
|||
Surcharge |
2110116 |
BASIC PLAN |
1.25 |
Y |
Y |
Jan'15 |
N |
|||
1 |
Y |
BASIC PLAN |
2110116 |
BASIC PLAN |
-105 |
Y |
Y |
Jan'15 |
N |
|
Preventive Care |
2110116 |
BASIC PLAN |
-5.00 |
Y |
Y |
Jan'15 |
N |
|||
Regional Tax |
2110116 |
BASIC PLAN |
-2.75 |
Y |
Y |
Jan'15 |
N |
|||
Office VisitCo-payment |
2110116 |
BASIC PLAN |
5.00 |
Y |
Y |
Jan'15 |
N |
|||
Surcharge |
2110116 |
BASIC PLAN |
-1.25 |
Y |
Y |
Jan'15 |
N |
|||
3 |
N |
BASIC PLAN |
2110116 |
BASIC PLAN |
105.00 |
Y |
Y |
Jan'15 |
N |
|
Preventive Care |
2110116 |
BASIC PLAN |
5.00 |
Y |
Y |
Jan'15 |
N |
|||
Office VisitCo-payment |
2110116 |
BASIC PLAN |
-7.00 |
Y |
Y |
Jan'15 |
N |
|||
Surcharge |
2110116 |
BASIC PLAN |
1.25 |
Y |
Y |
Jan'15 |
N |
Similar Financial Transaction Details exist for the financial transactions corresponding to the calculation period Feb'15 but with the Invoice Bulking Group set to Feb'15.
Financial Message Generation
The financial transactions are grouped by the policy (GID -1006) to generate a financial message. The various parts of the financial message are as follows
Financial Message
| Job ID | Message Date | Message Bulking Group |
|---|---|---|
132535 |
01-Jan-2015 |
1006 |
Financial Message - Invoice
The grouping of the financial transaction details into an invoice is based on the invoice grouping indicator and invoice bulking group. Here, the invoice grouping indicator is set to 'Y'. So, grouping of financial transaction details into invoices is expected. The invoice bulking group is set to the calculation period to which the financial transaction detail belongs to. Also, for every financial transaction with the financial message mandatory indicator set to 'Y', separate invoices must be created for its financial transaction details and, therefore, in this situation four invoices are created.
One invoice each is created for the financial transaction with message mandatory indicator set to 'Y' ( as no other distinct invoice bulking group criteria are specified on the financial transaction details that belong to the mandatory financial transaction).
Once the Financial Transaction Details that belong to the mandatory financial transactions are grouped into invoices, the remaining financial transaction details are grouped based on the invoice bulking group setting on the Financial Transaction Detail Process Data.
| Calculation Period Start Date | Version | Reversal | Financial Message Mandatory Indicator | Invoice Bulking Group | Invoice |
|---|---|---|---|---|---|
01-Jan-2015 |
1 |
N |
Y |
Jan’15 |
89077 |
1 |
Y |
Jan’15 |
89078 |
||
3 |
N |
Jan’15 |
89078 |
||
01-Feb-2015 |
1 |
N |
Y |
Feb’15 |
89079 |
1 |
Y |
Feb'15 |
89080 |
||
3 |
N |
Feb’15 |
89080 |
| ID | Invoice Type | Invoice Amount |
|---|---|---|
89077 |
Standard |
109.00 |
89078 |
Standard |
-4.75 |
89079 |
Standard |
109.00 |
89080 |
Standard |
-4.75 |
Financial Message - Invoice Line
The invoice line grouping indicator on the Financial Transaction Detail Process Data is set to 'Y', therefore the system groups multiple Financial Transaction Detail of each invoice into a single invoice line. However, no invoice line bulking group is specified and, therefore, the financial transaction details are grouped together based on only the Reversal Indicator (from Financial Transaction)
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89077 |
123621 |
1 |
ITEM |
109.00 |
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89078 |
123623 |
1 |
ITEM |
-109.00 |
89078 |
123624 |
2 |
ITEM |
104.25 |
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89079 |
123622 |
1 |
ITEM |
109.00 |
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89080 |
123625 |
1 |
ITEM |
-109.00 |
89080 |
123626 |
2 |
ITEM |
104.25 |
Accounting Details
The accounting details are placed within its corresponding invoice element. The accounting detail grouping indicator is set to 'N' for all the Financial Transaction Details and, therefore, an accounting detail is created for each Financial Transaction Detail.
Accounting Details - Invoice Id 89077
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719070 |
32423432 |
01-Jan-2015 |
105.00 |
8719071 |
32423432 |
01-Jan-2015 |
5.00 |
8719072 |
32423430 |
01-Jan-2015 |
2.75 |
8719073 |
32423431 |
01-Jan-2015 |
-5.00 |
8719074 |
32423430 |
01-Jan-2015 |
1.25 |
Accounting Details - Invoice Id 89078
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719080 |
32423432 |
01-Jan-2015 |
-105.00 |
8719081 |
32423432 |
01-Jan-2015 |
-5.00 |
8719082 |
32423430 |
01-Jan-2015 |
-2.75 |
8719083 |
32423431 |
01-Jan-2015 |
5.00 |
8719084 |
32423430 |
01-Jan-2015 |
-1.25 |
8719085 |
32423432 |
01-Jan-2015 |
105.00 |
8719086 |
32423432 |
01-Jan-2015 |
5.00 |
8719087 |
32423431 |
01-Jan-2015 |
-7.00 |
8719088 |
32423430 |
01-Jan-2015 |
1.25 |
Accounting Details - Invoice Id 89079
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719075 |
32423432 |
01-Jan-2015 |
105.00 |
8719076 |
32423432 |
01-Jan-2015 |
5.00 |
8719077 |
32423430 |
01-Jan-2015 |
2.75 |
8719078 |
32423431 |
01-Jan-2015 |
-5.00 |
8719079 |
32423430 |
01-Jan-2015 |
1.25 |
Accounting Details - Invoice Id 89080
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719089 |
32423432 |
01-Jan-2015 |
-105.00 |
8719090 |
32423432 |
01-Jan-2015 |
-5.00 |
8719091 |
32423430 |
01-Jan-2015 |
-2.75 |
8719092 |
32423431 |
01-Jan-2015 |
5.00 |
8719093 |
32423430 |
01-Jan-2015 |
-1.25 |
8719094 |
32423432 |
01-Jan-2015 |
105.00 |
8719095 |
32423432 |
01-Jan-2015 |
5.00 |
8719096 |
32423431 |
01-Jan-2015 |
-7.00 |
8719097 |
32423430 |
01-Jan-2015 |
1.25 |
Apart from the grouping criteria mentioned above, more variations are possible. For example
-
Grouping the financial transactions based on the 'Bill To' setting on a group account, invoices per policy holder, invoice lines and accounting details per policy enrollment on the policy.
-
Grouping the financial transactions per group account, invoices per policy enrollment, no grouping on the invoice lines and accounting details.
These variations can be achieved by implementing 'Financial Transaction' and 'Financial Transaction Detail' function dynamic logic and setting the desired values for the various bulking group criteria.