Scenario 1
In this capitation scenario a payment arrangement for calendar year 2018 is made between the healthcare payer and primary care providers (through a contracting administration organization which is paid a fixed amount per attributed member) that are part of a specific provider network. The providers are paid a monthly rate amount per attributed member (above the age of 16) based on their grade and the member’s gender and age. If the member has a medical condition, the base rate amount is increased based on the member’s age. A provider is only paid if he/she has at least 200 attributed members. No payment is made at all to a provider if he/she is classified as a fraud.
Configuration
In the sections below the default time periods, rates, adjustments and capitation contract that are configured for the above specified scenario are described.
Default Time Periods
The payment arrangement is made for calendar year 2018, so a default time period is configured for calendar year 2018. The rates and adjustments that are specified in the sections below are in the context of this default time period.
Default Time Periods
| Display Name | Start Date | End Date |
|---|---|---|
Calendar Year 2018 |
01-01-2018 |
12-31-2018 |
Rates
The base rate amount that a provider is paid per member is based on his/her grade and the member’s gender and age, so a schedule definition with dimensions for provider grade, member gender and member age is configured.
Schedule Definition
| Code | Description | Type | Condition |
|---|---|---|---|
GRADE GEN AGE BASED |
Provider grade and member gender and age based rates |
Rate |
RSLE MEM GEN AGE |
Schedule Dimensions
| Display Name | Field Name | Type | Usage |
|---|---|---|---|
Provider Grade |
providerGrade |
Dynamic Field (provider.grade) |
Value |
Member Gender |
memberGender |
Generic (char) |
Value |
Member Age |
memberAge |
Generic (nr) |
Range |
To compare the gender and the age of the member with the values on the rate schedule lines, a dynamic logic condition with signature Rate Schedule Line Evaluation is configured.
Dynamic Logic
| Code | Signature | Logic |
|---|---|---|
RSLE MEM GEN AGE |
Rate Schedule Line Evaluation |
def gender = attribution.person.gender def age = attribution.person.getAge(referenceDate) return rateScheduleLine.memberAge?.fromValue !=null && age >= rateScheduleLine.memberAge?.fromValue && (age ⇐ rateScheduleLine.memberAge?.toValue || rateScheduleLine.memberAge?.toValue == null) && rateScheduleLine.memberGender == gender |
A rate schedule is configured with rate schedule lines for the default time period "Calendar Year 2018", based on the above specified schedule definition.
Rate Schedule
| Code | Schedule Definition | Amount Interpretation | Currency |
|---|---|---|---|
GRADE GEN AGE BASED RATES |
GRADE GEN AGE BASED |
Contract Calculation Period |
$ |
Rate Schedule Lines
| Provider Grade | Member Gender | Member Age From | Member Age Through | Rate |
|---|---|---|---|---|
1 |
M |
0 |
18 |
10.00 $ |
1 |
M |
19 |
64 |
15.00 $ |
1 |
M |
65 |
20.00 $ |
|
2 |
M |
0 |
18 |
12.00 $ |
2 |
M |
19 |
64 |
17.00 $ |
2 |
M |
65 |
22.00 $ |
|
3 |
M |
0 |
18 |
15.00 $ |
3 |
M |
19 |
64 |
20.00 $ |
3 |
M |
65 |
25.00 $ |
|
1 |
F |
0 |
18 |
11.00 $ |
1 |
F |
19 |
64 |
16.00 $ |
1 |
F |
65 |
21.00 $ |
|
2 |
F |
0 |
18 |
13.00 $ |
2 |
F |
19 |
64 |
18.00 $ |
2 |
F |
65 |
23.00 $ |
|
3 |
F |
0 |
18 |
16.50 $ |
3 |
F |
19 |
64 |
21.50 $ |
3 |
F |
65 |
26.50 $ |
Adjustments
A number of contract specific and generic adjustments apply to the base rate amount:
-
Medical condition adjustment (contract specific)
-
Administration fee adjustment (contract specific)
-
Provider fraud adjustment (generic)
Medical Condition
If the member has a medical condition, the base rate amount is increased based on the member’s age, so a schedule definition with dimensions for member age and medical condition is configured.
Schedule Definition
| Code | Description | Type | Condition |
|---|---|---|---|
AGE MED COND BASED |
Member age and medical condition based adjustments |
Adjustment |
ASLE MEM AGE |
Schedule Dimensions
| Display Name | Field Name | Type | Usage |
|---|---|---|---|
Member Age |
memberAge |
Generic (nr) |
Range |
Member Medical Condition |
medCondition |
Dynamic Field (person.medCondition) |
Value |
To compare the age of the member with the values on the adjustment schedule lines, a dynamic logic condition with signature Adjustment Schedule Line Evaluation is configured.
Dynamic Logic
| Code | Signature | Logic |
|---|---|---|
ASLE MEM AGE |
Adjustment Schedule Line Evaluation |
def age = attribution.person.getAge(referenceDate) return adjustmentScheduleLine.memberAge?.fromValue !=null && age >= adjustmentScheduleLine.memberAge?.fromValue && (age ⇐ adjustmentScheduleLine.memberAge?.toValue || adjustmentScheduleLine.memberAge?.toValue == null) |
An adjustment schedule is configured with adjustment schedule lines for default time period "Calendar Year 2018", based on the above specified schedule definition. This adjustment only applies to specific contracts so the adjustment type is set to Contract. If the member does not have a medical condition no adjustment is applied, but because the provider needs to be informed of the outcome of this evaluation an adjustment schedule line with an adjustment of 0 % is configured for members with no medical condition.
Adjustment Schedule
| Code | Schedule Definition | Adjust. Type |
|---|---|---|
MED COND ADJUSTMENT |
AGE MED COND BASED |
Contract |
Adjustment Schedule Lines
| Member Age From | Member Age Through | Member Medical Condition | Adjustment |
|---|---|---|---|
N |
0 % |
||
0 |
18 |
Y |
20 % |
19 |
64 |
Y |
25 % |
65 |
Y |
30 % |
Administration Fee
The contracting administration organization is paid a fixed amount per attributed member, regardless of any dimensions, so a schedule definition without any dimensions is configured.
Schedule Definition
| Code | Description | Type |
|---|---|---|
NO DIMENSIONS |
Adjustments without dimensions |
Adjustment |
An adjustment schedule is configured with adjustment schedule lines for default time period "Calendar Year 2018", based on the above specified schedule definition. This adjustment only applies to specific contracts so the adjustment type is set to Contract.
Adjustment Schedule
| Code | Schedule Definition | Adjust. Type | Amount Interpretation | Curr. |
|---|---|---|---|---|
ADMIN FEE |
NO DIMENSIONS |
Contract |
Contract Calculation Period |
$ |
Adjustment Schedule Lines
| Adjustment |
|---|
2.00 $ |
Provider Fraud
No payment is made at all to a provider if he/she is classified as a fraud, so a schedule definition with a dimension for provider fraud is configured.
Schedule Definition
| Code | Description | Type |
|---|---|---|
PROV FRAUD |
Provider fraud adjustments |
Adjustment |
Schedule Dimensions
| Display Name | Field Name | Type | Usage |
|---|---|---|---|
Provider Fraud |
providerFraud |
Dynamic Field (provider.fraud) |
Value |
An adjustment schedule is configured with adjustment schedule lines for default time period "Calendar Year 2018", based on the above specified schedule definition. This is a generic rule (across contracts), so the adjustment type is set to Generic. The adjustment applies after all contract specific adjustments have been applied, so the generic adjustment evaluation is set to After Contract Adjustments.
Adjustment Schedule
| Code | Schedule Definition | Adjust. Type | Generic Adjust. Evaluation |
|---|---|---|---|
PROV FRAUD ADJUSTMENT |
PROV FRAUD |
Generic |
After Contract Adjustments |
Adjustment Schedule Lines
| Provider Fraud | Adjustment |
|---|---|
Y |
-100 % |
Capitation Contract
A capitation contract is configured that uses the GRADE AGE BASED RATES rate schedule. Payment is made directly to the providers, so the attribution type of the contract is set to Member and Provider. The contracting administration organization through which the payment arrangement is made, is specified on the contract. Providers are only paid for members above the age of 16, so a contract alignment filter condition is added to the contract.
Capitation Contracts
| Code | Description | Attribution Type | Rate Schedule | Contracting Organization | Reference Date Function | Contract Alignment Filter Condition |
|---|---|---|---|---|---|---|
PCP CONTRACT |
Primary Care Providers Contract |
Member and Provider |
GRADE GEN AGE BASED RATES |
O562 |
RD CP ED |
CAF MEM AGE |
In the sections below the contract calculation periods, contract provider filter rules, contract adjustments, contract rate splits and dynamic logic that are part of this contract are described.
Contract Calculation Periods
Providers are paid a monthly rate per member if they have at least 200 attributed members, so for each month in 2018 a contract calculation period is configured with an attribution threshold of 200.
Contract Calculation Periods
| Start Date | End Date | Attribution Threshold |
|---|---|---|
01-01-2018 |
01-31-2018 |
200 |
02-01-2018 |
02-28-2018 |
200 |
03-01-2018 |
03-31-2018 |
200 |
04-01-2018 |
04-30-2018 |
200 |
05-01-2018 |
05-31-2018 |
200 |
06-01-2018 |
06-30-2018 |
200 |
07-01-2018 |
07-31-2018 |
200 |
08-01-2018 |
08-31-2018 |
200 |
09-01-2018 |
09-30-2018 |
200 |
10-01-2018 |
10-31-2018 |
200 |
11-01-2018 |
11-30-2018 |
200 |
12-01-2018 |
12-31-2018 |
200 |
Contract Provider Filter Rules
The contract only applies to primary care providers that are in the PCP PROVIDERS network, so a contract provider filter rule is configured with a PCP provider assignment type, a PCP PROVIDERS provider group and an attribution filter condition that verifies that the provider has the PCP specialty.
Contract Provider Filter Rules
| Sequence | Provider Assignment Type | Provider Group | Attribution Filter Condition |
|---|---|---|---|
1 |
PCP |
PCP PROVIDERS |
PFR PRV GRADE |
Contract Adjustments
The adjustment schedules of adjustment type Contract are added to contracts in the context of contract time periods, so a contract time period for calendar year 2018 is configured.
Contract Time Periods
| Display Name | Start Date | End Date |
|---|---|---|
Contract Year 2018 |
01-01-2018 |
12-31-2018 |
The medical condition and administration fee adjustments are added to the contract in the context of the above configured contract time period. They both apply to the base rate amount, so the sequence is set to 1.
Contract Adjustments
| Contract Time Period | Adjustment Schedule | Sequence |
|---|---|---|
Contract Year 2018 |
MED COND ADJUSTMENT |
1 |
Contract Year 2018 |
ADMIN FEE |
1 |
For specific adjustment schedule lines of the medical condition adjustment schedule, contract specific adjustment values apply, so contract adjustment overrides are configured for these adjustment schedule lines.
Contract Adjustment Overrides
| Adjustment Schedule | Adjustment Schedule Line | Adjustment |
|---|---|---|
MED COND ADJUSTMENT |
From 19 through 64 with a medical condition |
26 % |
MED COND ADJUSTMENT |
Above 65 with a medical condition |
32 % |
Contract Rate Splits
The contracting administration organization is paid a fixed amount per attributed member, which is configured using the ADMIN FEE adjustment schedule. A contract rate split is configured for this adjustment schedule, with the contracting administration organization specified as the payment receiver (receiving 100% of this fee). Another contract rate split is configured for all other rate/adjustment components, with the provider specified as the payment receiver (receiving 100% of these other rate/adjustment components).
Contract Rate Splits
| Split Level | Adjustment Schedule |
|---|---|
Adjustment |
ADMIN FEE |
All |
Contract Payment Receivers
| Contract Rate Split | Percentage | Payment Receiver Function |
|---|---|---|
Adjustment (ADMIN FEE) |
100 % |
PR ADMIN ORG |
All |
100 % |
PR PROVIDER |
Dynamic Logic
The dynamic logic conditions and functions that are used within the contract are configured as specified below.
Dynamic Logic
| Code | Signature | Logic |
|---|---|---|
RD CP ED |
Calculation Period Reference Date |
return contractCalculationPeriod.endDate |
CAF MEM AGE |
Contract Alignment Filter |
return contractAlignment.person.getAge(referenceDate) >= 16 |
PFR PRV GRADE |
Attribution Filter |
return attribution.provider.hasSpecialty('PCP') |
PR PROVIDER |
Payment Receiver |
return attribution.provider.code |
PR ADMIN ORG |
Payment Receiver |
return contractPaymentReceiver.contractRateSplit.capitationContract.organization?.code |
FT SET GROUPING |
Financial Transaction |
financialTransaction.financialTransactionProcessData.finTransactionSetGrouping = calculationResult.contractCalculationPeriod.capitationContract.code return financialTransaction |
Contract Alignments
A subset of the contract alignments, members and providers that are in the context of this contract are specified in the sections below.
Alignments
In the table below a number of contract alignments that apply to the contract are specified.
Contract Alignments
| Member | Start Date | End Date |
|---|---|---|
John Smith |
01-01-2018 |
12-31-2018 |
Alice Jones |
01-01-2018 |
12-31-2018 |
Robert Cooper |
01-01-2018 |
12-31-2018 |
Kevin Jackson |
01-01-2018 |
12-31-2018 |
Anne Willis |
01-01-2018 |
12-31-2018 |
Members
The members that are aligned to the contract have specific characteristics which are important in the context of this contract.
Members
| Name | Code | Gen. | Date of Birth | Med. Con. | Assigned Providers |
|---|---|---|---|---|---|
John Smith |
M631893 |
M |
08-08-1984 |
N |
Rodrigo Martinez (PCP from 01-01-2015) |
Alice Jones |
M259012 |
F |
10-06-1951 |
Y |
Rodrigo Martinez (PCP from 01-01-2000 to 01-15-2018) Michael Lawrence (PCP from 01-16-2018) |
Robert Cooper |
M458880 |
M |
03-21-2001 |
N |
Chris Downey (PCP from 03-21-2001) |
Kevin Jackson |
M632222 |
M |
01-16-1987 |
N |
Marta Dickson (PCP from 04-12-2012) |
Anne Willis |
M880654 |
F |
01-15-2004 |
N |
Rodrigo Martinez (PCP from 01-15-2004) |
Providers
The providers that are assigned to the above specified members have specific characteristics which are important in the context of this contract.
Providers
| Name | Code | Grade | Provider Group | Specialties | Fraud |
|---|---|---|---|---|---|
Rodrigo Martinez |
P10654 |
2 |
PCP PROVIDERS (from 01-01-2015) |
PCP (from 01-01-1999) |
N |
Michael Lawrence |
P33421 |
3 |
PCP PROVIDERS (from 01-01-2013) |
PCP (from 01-01-2013) |
N |
Chris Downey |
P67810 |
1 |
PCP PROVIDERS 2ND (from 01-01-2010) |
PCP (from 01-01-2000) |
N |
Marta Dickson |
P77788 |
1 |
PCP PROVIDERS (from 01-01-2017) |
PCP (from 01-01-2011) |
Y |
Calculation
When the Capitation Calculation activity is run for the contract with a calculation input date in January 2018, a number of attributions, calculation results and financial results are created based on the contract alignments and the configuration of the contract. The providers that are specified above all meet the attribution threshold of 200 attributed members.
Attributions
A number of attributions are created in the context of the contract alignments that are specified above. The attributions are only created for members John Smith, Alice Jones and Kevin Jackson. The assigned provider (Chris Downey) of member Robert Cooper is not part of the PCP PROVIDERS group, so no attributions are created for this member. The same counts for member Anne Willis, because she is below the age of 16. Note that two attributions are created for member Alice Jones, because she switched from one provider to another provider mid-January 2018.
Attributions
| Member | Calc. Period | Provider | Start Date | End Date |
|---|---|---|---|---|
John Smith |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
01-31-2018 |
Alice Jones |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
01-15-2018 |
Alice Jones |
January 2018 |
Michael Lawrence |
01-16-2018 |
01-31-2018 |
Kevin Jackson |
January 2018 |
Marta Dickson |
01-01-2018 |
01-31-2018 |
Calculation Results
For every attribution a calculation result with calculation result lines is created, based on the configured rate and adjustment schedules.
Calculation Results
| Member | Calc. Period | Provider | Attr. Start Date | Rate | Adj. | Result | Vers. | Rev. |
|---|---|---|---|---|---|---|---|---|
John Smith |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
17.00 $ |
2.00 $ |
19.00 $ |
1 |
N |
Alice Jones |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
11.13 $ |
4.53 $ |
15.66 $ |
1 |
N |
Alice Jones |
January 2018 |
Michael Lawrence |
01-16-2018 |
13.68 $ |
5.41 $ |
19.09 $ |
1 |
N |
Kevin Jackson |
January 2018 |
Marta Dickson |
01-01-2018 |
15.00 $ |
-15.00 $ |
0.00 $ |
1 |
N |
The calculation result lines are created per rate/adjustment component.
Calculation Result Lines
| Calculation Result | Seq. | Schedule | Am. Inter. | Retr. Value | Input Am. | Result |
|---|---|---|---|---|---|---|
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
1 |
GRADE AGE BASED RATES |
CCP |
17.00 $ |
17.00 $ |
|
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
17.00 $ |
2.00 $ |
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
3 |
MED COND ADJUSTMENT |
0 % |
17.00 $ |
0.00 $ |
|
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
1 |
GRADE AGE BASED RATES |
CCP |
23.00 $ |
11.13 $ |
|
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
11.13 $ |
0.97 $ |
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V1 |
3 |
MED COND ADJUSTMENT |
32 % |
11.13 $ |
3.56 $ |
|
Alice Jones - January 2018 (01-16-2018) - Michael Lawrence - V1 |
1 |
GRADE AGE BASED RATES |
CCP |
26.50 $ |
13.68 $ |
|
Alice Jones - January 2018 (01-16-2018) - Michael Lawrence - V1 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
13.68 $ |
1.03 $ |
Alice Jones - January 2018 (01-16-2018) - Michael Lawrence - V1 |
3 |
MED COND ADJUSTMENT |
32 % |
13.68 $ |
4.38 $ |
|
Kevin Jackson - January 2018 (01-01-2018) - Marta Dickson - V1 |
1 |
GRADE AGE BASED RATES |
CCP |
15.00 $ |
15.00 $ |
|
Kevin Jackson - January 2018 (01-01-2018) - Marta Dickson - V1 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
15.00 $ |
2.00 $ |
Kevin Jackson - January 2018 (01-01-2018) - Marta Dickson - V1 |
3 |
MED COND ADJUSTMENT |
0 % |
15.00 $ |
0.00 $ |
|
Kevin Jackson - January 2018 (01-01-2018) - Marta Dickson - V1 |
4 |
PROV FRAUD ADJUSTMENT |
-100 % |
17.00 $ |
-17.00 $ |
Financial Results
For every calculation result a base financial object is created.
Base Financial Objects
| Member Code | Contract Code | Calc. Period Start Date | Attr. Start Date | Provider Code |
|---|---|---|---|---|
M631893 |
PCP CONTRACT |
01-01-2018 |
01-01-2018 |
P10654 |
M259012 |
PCP CONTRACT |
01-01-2018 |
01-01-2018 |
P10654 |
M259012 |
PCP CONTRACT |
01-01-2018 |
01-16-2018 |
P33421 |
M632222 |
PCP CONTRACT |
01-01-2018 |
01-01-2018 |
P77788 |
For every base financial object a financial transaction is created.
Financial Transactions
| Base Financial Object | Total Am. | Rev. | Vers. |
|---|---|---|---|
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
19.00 $ |
N |
1 |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
15.66 $ |
N |
1 |
M259012 - PCP CONTRACT - P33421 - January 2018 (01-16-2018) |
19.09 $ |
N |
1 |
M632222 - PCP CONTRACT - P77788 - January 2018 (01-01-2018) |
0.00 $ |
N |
1 |
The financial transaction details are created per rate/adjustment component.
Financial Transaction Details
| Financial Transaction | Seq. | Component Code | Counterparty Code[1] | Amount |
|---|---|---|---|---|
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
1 |
GRADE AGE BASED RATES |
P10654 |
17.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
2 |
ADMIN FEE |
O562 |
2.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
3 |
MED COND ADJUSTMENT |
P10654 |
0.00 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
1 |
GRADE AGE BASED RATES |
P10654 |
11.13 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
2 |
ADMIN FEE |
O562 |
0.97 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed N |
3 |
MED COND ADJUSTMENT |
P10654 |
3.56 $ |
M259012 - PCP CONTRACT - P33421 - January 2018 (01-16-2018) - V1 - Reversed N |
1 |
GRADE AGE BASED RATES |
P33421 |
13.68 $ |
M259012 - PCP CONTRACT - P33421 - January 2018 (01-16-2018) - V1 - Reversed N |
2 |
ADMIN FEE |
O562 |
1.03 $ |
M259012 - PCP CONTRACT - P33421 - January 2018 (01-16-2018) - V1 - Reversed N |
3 |
MED COND ADJUSTMENT |
P33421 |
4.38 $ |
M632222 - PCP CONTRACT - P77788 - January 2018 (01-01-2018) - V1 - Reversed N |
1 |
GRADE AGE BASED RATES |
P77788 |
15.00 $ |
M632222 - PCP CONTRACT - P77788 - January 2018 (01-01-2018) - V1 - Reversed N |
2 |
ADMIN FEE |
O562 |
2.00 $ |
M632222 - PCP CONTRACT - P77788 - January 2018 (01-01-2018) - V1 - Reversed N |
3 |
MED COND ADJUSTMENT |
P77788 |
0.00 $ |
M632222 - PCP CONTRACT - P77788 - January 2018 (01-01-2018) - V1 - Reversed N |
4 |
PROV FRAUD ADJUSTMENT |
P77788 |
-17.00 $ |
Recalculation
Let’s consider that the grade of provider Rodrigo Martinez is retroactively (effective from 01-01-2018) changed from 2 to 3. This change is monitored by a configured change event rule of type Recalculation, which results in the creation of a contract mutation with a reference to the affected provider. When the Capitation Calculation activity is run for the contract with a calculation input date in February 2018 (and look back date 01-01-2018) new results are of course created for February 2018, but because a contract mutation exists some of the existing results are reversed and new results are created.
The existing calculation results for provider Rodrigo Martinez are reversed and new calculation results are created.
Calculation Results
| Member | Calc. Period | Provider | Attr. Start Date | Rate | Adj. | Result | Vers. | Rev. |
|---|---|---|---|---|---|---|---|---|
John Smith |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
17.00 $ |
2.00 $ |
19.00 $ |
1 |
Y |
John Smith |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
20.00 $ |
2.00 $ |
22.00 $ |
2 |
N |
Alice Jones |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
11.13 $ |
4.53 $ |
15.66 $ |
1 |
Y |
Alice Jones |
January 2018 |
Rodrigo Martinez |
01-01-2018 |
12.82 $ |
5.07 $ |
17.89 $ |
2 |
N |
New calculation result lines are created for the new calculation results.
Calculation Result Lines
| Calculation Result | Seq. | Schedule | Am. Inter. | Retr. Value | Input Am. | Result |
|---|---|---|---|---|---|---|
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
1 |
GRADE AGE BASED RATES |
CCP |
20.00 $ |
20.00 $ |
|
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
20.00 $ |
2.00 $ |
John Smith - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
3 |
MED COND ADJUSTMENT |
0 % |
20.00 $ |
0.00 $ |
|
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
1 |
GRADE AGE BASED RATES |
CCP |
26.50 $ |
12.82 $ |
|
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
2 |
ADMIN FEE |
CCP |
2.00 $ |
12.82 $ |
0.97 $ |
Alice Jones - January 2018 (01-01-2018) - Rodrigo Martinez - V2 |
3 |
MED COND ADJUSTMENT |
32 % |
12.82 $ |
4.10 $ |
Reversal financial transactions for the reversed calculation results and new financial transactions for the new calculation results are created for provider Rodrigo Martinez.
Financial Transactions
| Base Financial Object | Total Am. | Rev. | Vers. |
|---|---|---|---|
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
-19.00 $ |
Y |
1 |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
22.00 $ |
N |
2 |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
-15.66 $ |
Y |
1 |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) |
17.89 $ |
N |
2 |
New and reversal financial transaction details are created for the above specified financial transactions.
Financial Transaction Details
| Financial Transaction | Seq. | Component Code | Counterparty Code[1] | Amount |
|---|---|---|---|---|
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
1 |
GRADE AGE BASED RATES |
P10654 |
-17.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
2 |
ADMIN FEE |
O562 |
-2.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
3 |
MED COND ADJUSTMENT |
P10654 |
0.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
1 |
GRADE AGE BASED RATES |
P10654 |
20.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
2 |
ADMIN FEE |
O562 |
2.00 $ |
M631893 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
3 |
MED COND ADJUSTMENT |
P10654 |
0.00 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
1 |
GRADE AGE BASED RATES |
P10654 |
-11.13 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
2 |
ADMIN FEE |
O562 |
-0.97 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V1 - Reversed Y |
3 |
MED COND ADJUSTMENT |
P10654 |
-3.56 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
1 |
GRADE AGE BASED RATES |
P10654 |
12.82 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
2 |
ADMIN FEE |
O562 |
0.97 $ |
M259012 - PCP CONTRACT - P10654 - January 2018 (01-01-2018) - V2 - Reversed N |
3 |
MED COND ADJUSTMENT |
P10654 |
4.10 $ |