SAP ABAP IMG Activity SIMG_CFMENUNMOHNK30 (Maintain Preapproved Insurance)
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 SIMG_CFMENUNMOHNK30 Maintain Preapproved Insurance  
Transaction Code S_KK4_74000062   IMG Activity: SIMG_CFMENUNMOHNK30 
Created on 19990816    
Customizing Attributes SIMG_CFMENUNMOHNK30   Maintain Preapproved Insurance 
Customizing Activity SIMG_CFMENUNMOHNK30   Maintain Preapproved Insurance 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name SIMG_CFMENUNMOHNK30    

In this IMG activity, you enter institution-specific pr-approved insurance for the insurance verification process. This time-dependent information indicates that certain insurance providers reimburse a given percentage or cost of a particular service without a request for insurance verification having to be submitted beforehand.

Pre-approved insurance results in the automatic creation of items in insurance verification documents that are assigned the status confirmed.

Pre-approved insurance takes precedence over default values.

You can specify an insurance provider type

instead of an insurance provider. In this way, the pre-approved insurance applies to all insurance providers of this type. You can also specify pre-approved insurance for self-payers.

The same applies for services. You can specify service groups instead of individual services. In this way, the pre-approved insurance applies for all services in this group, regardless of whether they were actually performed.

Example

Requirements

You must have already created:

  • The institution
  • The insurance providers or insurance provider types
  • The services you want to use in pre-approved insurance

The pre-approved insurance must relate to services in a billing catalog.

Standard settings

Recommendation

Activities

You enter a pre-approved insurance by specifying:

  • An institution (under a four-character key) in the Inst. field
  • The insurance provider type in the IPT field and the insurance provider in the Ins.Prov. field, or by selecting Self-Payer (S)
  • The in-house service catalog in the SC field
  • The service or service group in the Service field
  • The extent of coverage either as
    • A percentage in the Rate field or
    • A maximum price in the Max. Price field.

Further notes

  • Pre-approved insurance for individual insurance providers takes precedence over pre-approved insurance for insurance provider types.
  • Pre-approved insurance for an individual service takes precedence over pre-approved insurance for a service group.

You should only transport pre-approved insurance from one system to another after consultation with SAP.

Business Attributes
ASAP Roadmap ID 204   Establish Functions and Processes 
Mandatory / Optional 2   Optional activity 
Critical / Non-Critical 2   Non-critical 
Country-Dependency E   Invalid for countries specified 
Customizing Attributes Country Key Country Name
SIMG_CFMENUNMOHNK30 NL Netherlands
Assigned Application Components
Documentation Object Class Documentation Object Name Current line number Application Component Application Component Name
SIMG SIMG_CFMENUNMOHNK30 0 I010004222 Insurance Verification 
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_NKIP_1 V - View NK30 01 Define Preapproved Insurance for Insurance Verification 
History
Last changed by/on SAP  19990816 
SAP Release Created in