Scenario C
This scenario focuses on the impact on the financial processing when the Financial Message Mandatory Indicator on the Financial Transaction Process Data of the financial transactions is set to 'Y'. This indicator, when set to 'Y', ensures that financial processing does not supersede the financial transaction and is part of the financial message.
Setting this indicator to 'Y' has impact on the following activities
-
Supersede Financial Transaction
-
Generate Financial Message
Policy 1003
Policy 1003 has the following properties:
- Policy Code
-
POL1003
- Group Account
-
-
- Collection Frequency
-
2[1]
- Member
-
2110114 (lives in a state where a 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 a policy 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 |
|---|---|---|---|---|---|---|---|
POL1003 |
1 |
1 |
Jan'15 |
110.00 |
-5.00 |
4.00 |
109.00 |
POL1003 |
2 |
2 |
Jan'15 |
110.00 |
-7.00 |
4.00 |
107.00 |
POL1003 |
2 |
3 |
Jan'15 |
110.00 |
-7.00 |
1.25 |
104.25 |
POL1003 |
1 |
1 |
Feb'15 |
110.00 |
-5.00 |
4.00 |
109.00 |
POL1003 |
2 |
2 |
Feb'15 |
110.00 |
-7.00 |
4.00 |
107.00 |
POL1003 |
2 |
3 |
Feb'15 |
110.00 |
-7.00 |
1.25 |
104.25 |
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 |
110.00 |
2.5 |
- |
2.75 |
Regional Tax |
|||
4 |
- |
- |
- |
-5.00 |
Office Visit Co-payment |
|||
5 |
- |
- |
- |
1.25 |
Surcharge |
|||
Jan'15 |
2 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
110.00 |
2.5 |
- |
2.75 |
Regional Tax |
|||
4 |
- |
- |
- |
-7.00 |
Office Visit Co-payment |
|||
5 |
- |
- |
- |
1.25 |
Surcharge |
|||
Jan'15 |
3 |
1 |
- |
- |
- |
105 .00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
- |
- |
- |
-7.00 |
Office Visit Co-payment |
|||
4 |
- |
- |
- |
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 |
|||
Feb'15 |
2 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
110.00 |
2.5 |
- |
2.75 |
Regional Tax |
|||
4 |
- |
- |
- |
-7.00 |
Office Visit Co-payment |
|||
5 |
- |
- |
- |
1.25 |
Surcharge |
|||
Feb'15 |
3 |
1 |
- |
- |
- |
105.00 |
BASIC PLAN Premium |
|
2 |
- |
- |
- |
5.00 |
Preventive Care |
|||
3 |
- |
- |
- |
-7.00 |
Office Visit Co-payment |
|||
4 |
- |
- |
- |
1.25 |
Surcharge |
Financial Data
Base Financial Object
| Calculation Period Start Date | Policy | Status |
|---|---|---|
01-Jan-2015 |
1003 |
Initial |
01-Feb-2015 |
1003 |
Initial |
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 |
2 |
N |
|||||
01-Jan-2015 |
2 |
Y |
|||||
01-Jan-2015 |
3 |
N |
|||||
01-Feb-2015 |
1 |
N |
Y |
||||
01-Feb-2015 |
1 |
Y |
|||||
01-Feb-2015 |
2 |
N |
|||||
01-Feb-2015 |
2 |
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 | Seq. Number | Invoice Indicator | Invoice Line Grouping Indicator | Accounting Detail Grouping Indicator |
|---|---|---|---|---|---|---|---|---|---|
1 |
N |
BASIC PLAN |
2110113 |
BASIC PLAN |
105.00 |
1 |
Y |
N |
N |
Preventive Care |
2110113 |
BASIC PLAN |
5.00 |
2 |
Y |
N |
N |
||
Regional Tax |
2110113 |
BASIC PLAN |
2.75 |
3 |
Y |
N |
N |
||
Office VisitCo-payment |
2110113 |
BASIC PLAN |
-5.00 |
4 |
Y |
N |
N |
||
Surcharge |
2110113 |
BASIC PLAN |
1.25 |
5 |
Y |
N |
N |
||
1 |
Y |
BASIC PLAN |
2110113 |
BASIC PLAN |
-105 |
1 |
Y |
N |
N |
Preventive Care |
2110113 |
BASIC PLAN |
-5.00 |
2 |
Y |
N |
N |
||
Regional Tax |
2110113 |
BASIC PLAN |
-2.75 |
3 |
Y |
N |
N |
||
Office VisitCo-payment |
2110113 |
BASIC PLAN |
5.00 |
4 |
Y |
N |
N |
||
Surcharge |
2110113 |
BASIC PLAN |
-1.25 |
5 |
Y |
N |
N |
||
2 |
N |
BASIC PLAN |
2110113 |
BASIC PLAN |
105 |
1 |
Y |
N |
N |
Preventive Care |
2110113 |
BASIC PLAN |
5.00 |
2 |
Y |
N |
N |
||
Regional Tax |
2110113 |
BASIC PLAN |
-2.75 |
3 |
Y |
N |
N |
||
Office VisitCo-payment |
2110113 |
BASIC PLAN |
-7.00 |
4 |
Y |
N |
N |
||
Surcharge |
2110113 |
BASIC PLAN |
1.25 |
5 |
Y |
N |
N |
||
2 |
Y |
BASIC PLAN |
2110113 |
BASIC PLAN |
-105 |
1 |
Y |
N |
N |
Preventive Care |
2110113 |
BASIC PLAN |
-5.00 |
2 |
Y |
N |
N |
||
Regional Tax |
2110113 |
BASIC PLAN |
2.75 |
3 |
Y |
N |
N |
||
Office VisitCo-payment |
2110113 |
BASIC PLAN |
7.00 |
4 |
Y |
N |
N |
||
Surcharge |
2110113 |
BASIC PLAN |
-1.25 |
5 |
Y |
N |
N |
||
3 |
N |
BASIC PLAN |
2110113 |
BASIC PLAN |
105.00 |
1 |
Y |
N |
N |
Preventive Care |
2110113 |
BASIC PLAN |
5.00 |
2 |
Y |
N |
N |
||
Office VisitCo-payment |
2110113 |
BASIC PLAN |
-7.00 |
3 |
Y |
N |
N |
||
Surcharge |
2110113 |
BASIC PLAN |
1.25 |
4 |
Y |
N |
N |
Similar Financial Transaction Details are also created for the Base financial Object for Feb'15 for this policy.
Financial Processing
The activity Select Financial Transactions into Set adds these financial transactions to a Financial Transaction Set - Premium Calculation Jan'15.
Next, the Supersede Financial Transactions activity supersedes those financial transactions that do not need to be included in the financial message. The table below depicts the result at the end of Supersede Financial Transaction activity
Base Financial Object
| Calculation Period Start Date | Policy GID | Status |
|---|---|---|
01-Jan-2015 |
1003 |
Supersede and Reversal Done |
01-Feb-2015 |
1003 |
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 |
Y |
|||
01-Jan-2015 |
1 |
Y |
Premium Calculation Jan'15 |
||||
01-Jan-2015 |
2 |
N |
Premium Calculation Jan'15 |
Y |
|||
01-Jan-2015 |
2 |
Y |
Premium Calculation Jan'15 |
Y |
|||
01-Jan-2015 |
3 |
N |
Premium Calculation Jan'15 |
||||
01-Feb-2015 |
1 |
N |
Premium Calculation Jan'15 |
Y |
|||
01-Feb-2015 |
1 |
Y |
Premium Calculation Jan'15 |
||||
01-Feb-2015 |
2 |
N |
Premium Calculation Jan'15 |
Y |
|||
01-Feb-2015 |
2 |
Y |
Premium Calculation Jan'15 |
Y |
|||
01-Feb-2015 |
3 |
N |
Premium Calculation Jan'15 |
The Supersede Financial Transaction activity does not supersede the financial transaction version 1 and its reversal because the financial message mandatory indicator is 'Y'. However, it does supersede the financial transaction version 2 (which does not have this indicator set to 'Y') and its reversal.
The next step is to Generate Financial Message. In this example we run the Generate Financial Message activity on 08-Feb-2015. The financial transaction version 1, the reversal of the financial transaction version 1 and financial transaction version 3 are included in the financial message. Since the Financial Transaction Process Data does not specify a financial message bulking group, the system groups all financial transactions for Jan'15 and Feb'15 into one message.
Financial Message
The contents of the various parts of the financial message are as follows:
Financial Message
| Job ID | Message Date | Message Bulking Group |
|---|---|---|
132533 |
08-Feb-2015 |
1003 |
Financial Message - Invoice
The grouping of the financial transaction details into an invoice is based on invoice grouping indicator and invoice bulking group. Here the invoice group indicator is set to 'N'. So, no grouping of financial transactions details into invoices is expected. However, for every financial transaction with the financial message mandatory indicator set to 'Y', a separate invoice must be created and, therefore, in this situation three invoices are created.
| ID | Invoice Type | Invoice Amount |
|---|---|---|
89072 |
Standard |
109.00 |
89073 |
Standard |
109.00 |
89074 |
Standard |
-9.50 |
Financial Message - Invoice Line
For each financial transaction detail, an invoice line is created.
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89072 |
123587 |
1 |
ITEM |
105.00 |
89072 |
123588 |
2 |
ITEM |
5.00 |
89072 |
123589 |
3 |
ITEM |
2.75 |
89072 |
123590 |
4 |
ITEM |
-5.00 |
89072 |
123591 |
5 |
ITEM |
1.25 |
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89073 |
123592 |
1 |
ITEM |
105.00 |
89073 |
123593 |
2 |
ITEM |
5.00 |
89073 |
123594 |
3 |
ITEM |
2.75 |
89073 |
123595 |
4 |
ITEM |
-5.00 |
89073 |
123596 |
5 |
ITEM |
1.25 |
The reversal financial transaction version 1 is grouped within the same invoice with the next non-superseded financial transaction version - financial transactions version 3 (within the Base Financial Object).
| Invoice Id | Invoice Line Id | Line Number | Line Type | Amount |
|---|---|---|---|---|
89074 |
123597 |
1 |
ITEM |
-105.00 |
89074 |
123598 |
2 |
ITEM |
-5.00 |
89074 |
123599 |
3 |
ITEM |
-2.75 |
89074 |
123600 |
4 |
ITEM |
5.00 |
89074 |
123601 |
5 |
ITEM |
-1.25 |
89074 |
123602 |
6 |
ITEM |
105.00 |
89074 |
123603 |
7 |
ITEM |
5.00 |
89074 |
123604 |
8 |
ITEM |
-7.00 |
89074 |
123605 |
9 |
ITEM |
1.25 |
89074 |
123606 |
10 |
ITEM |
-105.00 |
89074 |
123607 |
11 |
ITEM |
-5.00 |
89074 |
123608 |
12 |
ITEM |
-2.75 |
89074 |
123609 |
13 |
ITEM |
5.00 |
89074 |
123610 |
14 |
ITEM |
-1.25 |
89074 |
123611 |
15 |
ITEM |
105.00 |
89074 |
123612 |
16 |
ITEM |
5.00 |
89074 |
123613 |
17 |
ITEM |
-7.00 |
89074 |
123614 |
18 |
ITEM |
1.25 |
The accounting details are placed within its corresponding invoice element.
Accounting Details - Invoice Id 89072
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719064 |
32423432 |
01-Jan-2015 |
105.00 |
8719065 |
32423432 |
01-Jan-2015 |
5.00 |
8719066 |
32423430 |
01-Jan-2015 |
2.75 |
8719067 |
32423431 |
01-Jan-2015 |
-5.00 |
8719068 |
32423430 |
01-Jan-2015 |
1.25 |
Accounting Details - Invoice Id 89073
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719069 |
32423432 |
01-Jan-2015 |
105.00 |
8719070 |
32423432 |
01-Jan-2015 |
5.00 |
8719071 |
32423430 |
01-Jan-2015 |
2.75 |
8719072 |
32423431 |
01-Jan-2015 |
-5.00 |
8719073 |
32423430 |
01-Jan-2015 |
1.25 |
Accounting Details - Invoice Id 89074
| Accounting Detail ID | Ledger ID | Accounting Date | Amount |
|---|---|---|---|
8719069 |
32423432 |
01-Jan-15 |
-105.00 |
8719070 |
32423432 |
01-Jan-15 |
-5.00 |
8719071 |
32423430 |
01-Jan-15 |
-2.75 |
8719072 |
32423431 |
01-Jan-15 |
5.00 |
8719073 |
32423430 |
01-Jan-15 |
-1.25 |
8719074 |
32423432 |
01-Jan-15 |
105.00 |
8719075 |
32423432 |
01-Jan-15 |
5.00 |
8719076 |
32423431 |
01-Jan-15 |
-7.00 |
8719077 |
32423430 |
01-Jan-15 |
1.25 |
8719078 |
32423432 |
01-Jan-15 |
-105.00 |
8719079 |
32423432 |
01-Jan-15 |
-5.00 |
8719080 |
32423430 |
01-Jan-15 |
-2.75 |
8719081 |
32423431 |
01-Jan-15 |
5.00 |
8719082 |
32423430 |
01-Jan-15 |
-1.25 |
8719083 |
32423432 |
01-Jan-15 |
105.00 |
8719084 |
32423432 |
01-Jan-15 |
5.00 |
8719085 |
32423431 |
01-Jan-15 |
-7.00 |
8719086 |
32423430 |
01-Jan-15 |
1.25 |
As the final step of creating the financial message, the system updates Financial Transaction Detail Process Data with the details of the invoice id, invoice line id and accounting detail id. The system also updates the Financial Transaction Process Data with the financial message creation datetime and financial message result.
The financial message creation date time and financial message result is set on the Financial Transaction Process Data. The table below provides an overview of the processed financial data.
Base Financial Object
| Calculation Period Start Date | Policy GID | Status |
|---|---|---|
01-Jan-2015 |
1003 |
Financial Message Handled |
01-Feb-2015 |
1003 |
Financial Message Handled |
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 |
Y |
08-Feb-2015 |
M |
|
01-Jan-2015 |
1 |
Y |
Premium Calculation Jan'15 |
08-Feb-2015 |
M |
||
01-Jan-2015 |
2 |
N |
Premium Calculation Jan'15 |
Y |
08-Feb-2015 |
S |
|
01-Jan-2015 |
2 |
Y |
Premium Calculation Jan'15 |
Y |
08-Feb-2015 |
S |
|
01-Jan-2015 |
3 |
N |
Premium Calculation Jan'15 |
08-Feb-2015 |
M |
||
01-Feb-2015 |
1 |
N |
Premium Calculation Jan'15 |
Y |
08-Feb-2015 |
M |
|
01-Feb-2015 |
1 |
Y |
Premium Calculation Jan'15 |
08-Feb-2015 |
M |
||
01-Feb-2015 |
2 |
N |
Premium Calculation Jan'15 |
Y |
08-Feb-2015 |
S |
|
01-Feb-2015 |
2 |
Y |
Premium Calculation Jan'15 |
Y |
08-Feb-2015 |
S |
|
01-Feb-2015 |
3 |
N |
Premium Calculation Jan'15 |
08-Feb-2015 |
M |