SAP ABAP IMG Activity ISH_SG_MEDISAVE_EST (SG: Medisave Claim Estimation)
Hierarchy
☛ BBPCRM (Software Component) BBPCRM
   ⤷ CRM (Application Component) Customer Relationship Management
     ⤷ CRM_APPLICATION (Package) All CRM Components Without Special Structure Packages
       ⤷ NBAS (Package) Appl. development Hospital System master data, catalogs
IMG Activity
ID ISH_SG_MEDISAVE_EST SG: Medisave Claim Estimation  
Transaction Code S_KK4_74000371   IMG Activity: ISH_SG_MEDISAVE_EST 
Created on 19990816    
Customizing Attributes ISH_SG_MEDISAVE_EST   SG: Medisave Claim Estimation 
Customizing Activity ISH_SG_MEDISAVE_EST   SG: Medisave Claim Estimation 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name ISH_SG_MEDISAVE_EST    

Introduction

Specifications relating to Medisave payments are required at various times during a patient's stay in your healthcare facility. However, this data is not transmitted to Medisave until the patient has been discharged. Consequently, confirmation of coverage by Medisave is not available at any time during the patient's stay. The expected Medisave payments must always be estimated.

In this IMG activity, you set the parameters that are relevant for the Medisave estimation. These parameters are institution-specific and time-dependent. The valid currency for all currency fields is the local currency of the institution.

Action Main General Estimation Parameters:

  • Group box Inpatient Cases
    • Field Daily Charge (daily charge for inpatient cases)
    • Field Phy. Fees (limit for physician's daily attendance fees for inpatient cases)
  • Group box Day Surgery Cases
    • Field Daily Charge (daily charge for day surgery cases)
    • Field Phy. Fees (limit for physician's daily attendance fees for day surgery cases)
  • Group box Psychiatric Cases
    • Field Daily Charge (daily charge for psychiatric cases)
    • Field Phy. Fees (limit for physician's daily attendance fees for psychiatric cases)
  • Group box Vaccinations
    • Amounts for hepatitis vaccinations in relation to three different age-groups
  • Group box Live Birth Restrictions
    • Restrictions for the number of living children delivered for obstetric cases and ligation
  • Group box Max.Amount field specifies the maximum Medisave
    • withdrawal with respect to surgical procedures.
    • Medisave claims shall:
    • Be limited to not more than three surgical procedures
    • Be limited to procedures involving not more than two anatomical systems (i.e. codes SA - SY) as defined in Tables of Surgical Operations; and not more than two procedures within each system
    • By subject to a maximum Medisave withdrawal of $XYZ for the total operations charges.

Estimation of Surgery-Related Services

With the action Maintain Tables of Operation you specify for each table of operation an amount claimable from Medisave.

Example

Requirements

Standard settings

Recommendation

Activities

Further notes

  • When delimiting the validity of these parameters make sure that the entries neither overlap nor leave a gap in coverage.

    Example:

    • Entries with two intervals 01/01/2000 - 06/30/2006 and 06/01/2006 - 12/31/9999 and an entry with two intervals 01/01/2006 - 05/30/2006 and 07/01/2006 - 12/31/9999 would be illegal.
    • The correct solution would be to create an entry with the intervals 01/01/2006 - 06/30/2006 and 07/01/2006 - 12/31/9999.

Business Attributes
ASAP Roadmap ID 203   Establish Master Data 
Mandatory / Optional 2   Optional activity 
Critical / Non-Critical 2   Non-critical 
Country-Dependency I   Valid for countries specified 
Customizing Attributes Country Key Country Name
ISH_SG_MEDISAVE_EST SG Singapore
Assigned Application Components
Documentation Object Class Documentation Object Name Current line number Application Component Application Component Name
SIMG ISH_SG_MEDISAVE_EST 0 I010004220 Insurance Relationship 
Maintenance Objects
Maintenance object type C   Customizing Object 
Assigned objects
Customizing Object Object Type Transaction Code Sub-object Do not Summarize Skip Subset Dialog Box Description for multiple selections
V_TN16DC V - View SM30 0000000000 Maintain General Estimation Parameters 
V_TN16OP V - View SM30 0000000000 Maintain Tables of Operation 
History
Last changed by/on SAP  20010528 
SAP Release Created in