Calculation Data Model

During capitation calculation processing, a number of entities are maintained. Attributions are created in the first part of the flow, before making any calculations. Then in the second part of the flow, attributions are used to calculate rates and adjustments based on the contract configuration; the results are stored in calculation results and calculation result lines.

All of these entities are next described in detail. In addition, capitation calculation processing maintains financial data; these are described in the Developer Guide for Financial Processing.

Attribution

An attribution shows the time valid connection between a member, a contract calculation period and a provider. Contracts of type 'Provider' lead to attributions where the provider is specified, contracts of type 'No Provider' lead to attributions where the provider is left unspecified. An attribution record stores the following information:

Table 1. Attribution

Fields	Description
Person	The member for which the calculation takes place
Contract Calculation Period	The contract calculation period for which the calculation takes place
Provider	The provider for which the calculation takes place
Start Date	The start date of the attribution
End Date	The end date of the attribution

Calculation Result

A calculation result record stores the following information:

Table 2. Calculation Result

Fields	Description
Person	The member for which the calculation is done
Contract Calculation Period	The contract calculation period for which the calculation is done
Provider	The provider for which the calculation is done
Attribution Start Date	The start date of the attribution
Attribution End Date	The end date of the attribution
Rate	The rate amount
Rate Currency	The currency of the rate
Adjustment	The sum of all adjustment amounts
Adjustment Currency	The currency of the sum of all adjustment amounts
Result	The result amount (Rate + Adjustment)
Result Currency	The currency of the result
Version	The version of the capitation calculation (the version number is incremented with each recalculation for the same person, contract calculation period, provider and attribution start date)
Reversed Indicator	Set to true when the calculation result is reversed; this can happen when: recalculation takes place an attribution is ended retroactively when calculation results already exist the activity is run for a contract calculation period when calculation results exist for alater period

Calculation Result Line

A calculation result line record stores the following information:

Table 3. Calculation Result Line

Fields	Description
Calculation Result	The calculation result to which the calculation result line belongs
Sequence	Specifies the order in which the steps have been applied (especially relevant for contract adjustments, for which the order is configurable)
Schedule	The rate schedule or adjustment schedule
Percentage	The percentage that was retrieved from the adjustment schedule line or contract adjustment override
Amount Interpretation	The interpretation setting of the rate schedule or adjustment schedule
Retrieved Amount	The amount that was retrieved (or calculated by a dynamic logic function) from the rate schedule line, adjustment schedule line or contract adjustment override; it also stores the amount after applying the percentage if the line is based on a percentage
Retrieved Amount Currency	The currency of the retrieved amount
Input Amount	The aggregated result of all preceding calculation steps that was the starting point for the calculation represented by this calculation result line
Input Amount Currency	The currency of the input amount
Result Amount	The delta amount that was the result of the calculation step represented by this calculation result line
Result Amount Currency	The currency of the result amount