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_PA_BEISPIEL | Display Examples |
| Transaction Code | S_KK4_74000427 | IMG Activity: ISH_PA_BEISPIEL |
| Created on | 19990816 | |
| Customizing Attributes | ISH_PA_BEISPIEL | Display Examples |
| Customizing Activity |
Document
| Document Class | SIMG | Hypertext: Object Class - Class to which a document belongs. |
| Document Name | ISH_PA_BEISPIEL |
Examples of System Settings in the Billing Area
The following examples provide you with an overview of the Customizing settings that must be made in order to satisfy various requirements on the billing process. For information on other Customizing settings, refer to the documentation on the respective IMG activities.
This document contains the following examples:
Example 1: Determine the Basic Price of a Service
Example 2: Configure Discount on Departmental per Diem Charges Pursuant to BPflV 1995 (§14, 2) - Federal Regulation for Hospitals Germany.
Example 1: Determine the basic price of a service
The following example illustrates the sequence of IMG activities that you need to perform to determine the basic price of a service during the billing process.
Example Data:
Institution: 1
You use two service catalogs in your institution. These are defined in the system as:
- Service catalog 01 (= in-house service catalog)
- Service catalog 02
You want to bill for service 65 in the in-house service catalog as service 100 in service catalog 02.
Activities
- Define Billing Types
Here you assign your (external) billing type IP to the (internal) billing type 1 predefined by SAP.
You can use the standard document pricing procedure A as your document pricing procedure (DPrc). It points to the standard pricing procedure for hospitals ISH001.
Note:
If you want to use another pricing procedure, for example, for outpatient billing, one way of doing this is to use your own document pricing procedure.
Example entry:
Ins: 1
BT: IP
Short Text: Inpat. Bill.
Description: Inpatient Billing
IB: 1
DPRc: A
- Determine Billing Types
Here you define the rules according to which the system is to use the (external) billing types. In our example, the system is to use billing type IP for inpatient cases (case type 1) (without further restriction on insurance providers, insurance provider types, billing OUs and movement type).
Example entry:
Inst.: 1
CT: 1
InsProv: *
IPT: *
Bill.OU: *
MT: 1
Bill.Type: IP
- Determine billing catalog
Here you define which services in the in-house service catalog you want to bill for using services in billing catalogs of your choosing. In this example, you bill for all services as they stand in the in-house service catalog, with the exception of service 65.
SAP provides rule type AB for billing.
Example entry, first line:
Inst.: 1
RT: AB
SC: 1
Service: *
Ins.Prov.: *
S:
IPT: *
BT: IP
Bill.Catalog: 1
Asgmt.Type: -->
Example entry, second line:
Inst.: 1
RT: AB
SC: 1
Service: 65
Ins.Prov.: *
S:
IPT: *
BT: IP
Bill.Catalog: 2
Asgmt. Type: -->
- Configure Service-Based Service Catalog Determination
If you want to use service-based re-mapping in service catalog determination, you have to set this parameter. If you do not enable this parameter, the system ignores the settings for service-based service catalog determination.
- Re-Map Service Codes
Here you define the rules according to which a service in the in-house service catalog is re-mapped to a service in the billing catalog. Here the validity period of the re-mapping should not lie outside that of the service.
Example entry:
Inst.: 1
SC: 1
Service: 65
Asgmt.Type: -->
SC: 2
Service: 100
Valid From: 01/01/2002
Valid To: 12/31/2005
- Determine Catalog Columns
Here you define the catalog column from which the system is to determine the basic price of a service in the billing process. In this example, for service catalog 1, the system determines the basic price from column 1. For service catalog 2, the system determines the basic price from column 3. Column 3 contains charge factors.
Example entry 1:
Inst.: 1
RT: AB
SC: 1
BT: IP
Valid From: 01/01/2002
Valid To: 12/31/9999
CL: 1
C:
Example entry 2:
Inst.: 1
RT: AB
SC: 2
BT: IP
Valid From: 01/01/2002
Valid To: 12/31/9999
Cl: 3
C: X
- Assign Currency Amount to Charge Factors
For charge factor columns, here you specify the currency amount which when multiplied by the charge factor gives the basic price of a service.
In this example, the currency amount is $0.10 for charge factor columns of service catalog 2 when services are billed for using billing type IP.
Example entry:
Inst.: 1
BT: IP
SC/>: 2
Service: *
Svce.Ctgry/>: *
Ins.Prov.: *
IPT: *
Valid From: 01/01/2002
Valid To: 12/31/9999
ChrgFctr value: 0.100
- Conditions
The pricing procedure delivered by SAP and the presettings it contains render any further Customizing activities for determining the basic price of a service unnecessary. The system automatically uses condition type GP00. It calculates the price by means of base value calculation formula 501 defined for this condition type and evaluated by the above table settings.
Example 2: Discount on Departmental per Diem Charges Pursuant to BPflV 1995 §14,2
A discount is to be calculated on the departmental per diem charge pursuant to BPflV 95 §14 (2). BPflV 95 stipulates that a discount is to be calculated for the departmental per diem charge of the department performing the surgery, if this department produces a surgical procedures surcharge.
- Create Condition Table
You should include the following fields from the field catalog (in the order given):
- Institution (technical name ISHEINRI)
- Case type (technical name ISHFALAR)
- Discount on departmental per diem indicator (technical name ISHAPFLA)
- Service catalog (technical name ISHABTAR)
- Service (technical name ISHABLST)
Alternatively, you can include the charge type (technical name ISHENTGA) instead of the service catalog and service.
You should use the option With validity period when you create your condition table.
- Define Access Sequences
Create the access sequence ZAPS for example.
Example entry accesses:
AcNo.: 1
Table: 900
Requiremnt: Discount Departmental per Diem BPflV 95
Exclusive:
Example entry fields:
Condition Doc. Field Source of Constant Init
ISHEINRI KOMK ISHEINRI Institution
ISHFALAR KOMK ISHFALAR Case Type
ISHAPFLA KOMP ISHAPFLA Discount DPD
ISHABTAR KOMK ISHABTAR Service Catalog
ISHABLST KOMP ISHABLST Service
Note:
You can set the I field to specify whether the system is to access the condition if the corresponding field is initial.
Generate the access sequence by choosing Utilities:
Usage: A
Application: V
Access sequence: ZAPS.
- Define Condition Types
You can also use ZAPS as the name of the condition type for calculating the 20% discount. You can use the standard condition type NWBA (chief physician discount -> client 000) as a reference for your condition type. The following settings are important here:
- Calculation Type Percentage: A
- Condition Class Surcharge or Discount: A
- Set Item Condition indicator
- Set Plus/Minus Indicator: X = discount
- Maintain Condition Records
Enter condition type ZAPS in the Condition Type field,&#
Business Attributes
| ASAP Roadmap ID | 204 | Establish Functions and Processes |
| Mandatory / Optional | 3 | Nonrequired activity |
| Critical / Non-Critical | 2 | Non-critical |
| Country-Dependency | A | Valid for all countries |
Assigned Application Components
| Documentation Object Class | Documentation Object Name | Current line number | Application Component | Application Component Name |
|---|---|---|---|---|
| SIMG | ISH_PA_BEISPIEL | 0 | I010004204 | Patient Accounting |
Maintenance Objects
| Maintenance object type |
History
| Last changed by/on | SAP | 19990816 |
| SAP Release Created in |
