Calculation Results UI

The calculation results page provides ability to view latest calculated results and navigate to its details. It also provides ability to get an aggregated overview of the totals at various levels. The page also provides the ability to filter for calculation results. The retrieval and display of data in this page is subject to restrictions described in the Security Guide for user access.

Filter By

The results can be filtered on the contract (a mandatory criteria), member, provider and calculation periods

Aggregation

It is possible to aggregate (sum) the rate, adjustments and result amounts over contract, members, providers and periods. The user must select the aggregation criteria to apply. The system first filters the results based on the Filter By, and then aggregates the results.

Results

The display of results depends on whether along with the filter aggregation is used or not.

Results Without Aggregation

The filtered results are displayed in a tabular format. For each calculation result the following information is displayed.

  • Contract Code

  • Calculation Period Start Date

  • Provider information

  • Member information

  • Rate

  • Adjustment

  • Result

Calcul;ation Results

It is possible to navigate to the details of each result using the action link 'Open'. The detail pages shows the calculation results and the lines.

Calculation Result Detail Page

Calculation Results Details

The following information is displayed for the calculation result:

  • Contract Code

  • Calculation Period Start Date

  • Provider information

  • Member information

  • Attributed Days

  • Attribution Start Date

  • Rate

  • Adjustment

  • Result

The following information is displayed for each calculation result lines:

  • Sequence

  • Schedule Definition

    • Rate Schedule Code or

    • Adjustment Schedule Code

  • Amount Interpretation

  • Retrieved Amount

  • Retrieved Percentage

  • Input Amount

  • Result

Results With Aggregation

When aggregation is applied, the calculation results page, shows the information based on the selected aggregation criteria and the totals - Total Rate, Total Adjustment, and Total Results, grouped by the criteria.

Table 1. Results With Aggregation
Criteria Information Displayed

Contract

Contract Code

Member

Member information

Provider

Provider information

Calculation Period

Calculation Periods Start Date
Calculation Results with Aggregation

Access Restrictions

Appropriate access grants must be provided to a user to be able to view calculation results.

  • Function Access grant to CP0012. This enables a user to access the Calculation Results Page. See Functional Access Restriction (JET) for more details.

  • The user must have access grant to GET operation for the following resources for LOVs to work:

    • contract

    • providers

    • persons