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  • The services and items pricelists will be limited only to those services as bundles and items that are allowed to be claimed during the reimbursement creation .through configuration

Claim creation

  • the services and items will be selected for the HF’s attached pricelists as before

  • if a flat fee bundle or fee-for-service bundle is selected

    • quantity is set to 1 and readonly

    • price is readonly and is calculated based on the bundle type

    • the sublist of configured services and items are listed under the selected bundle

      • quantity as 0 (quantity above the service bundle configuration is not allowed)

      • price is readonly

      • explication text input (will be used to recall authorization)

      • no delete button

      • the bundle price is automatically adjusted based on the rule:

        • flat fee bundle: if the quantity is less than the configuration the price is set to 0, if the quantity is higher than the configured quantity, the price will not change and remain at the configured total price

        • fee-for-service bundle: thebundle price will be the sum of consumed items and services defined in the configuration but limited to the configured total ceiling. Quantity of any services and items not used should be set to 0.

      • the DB will register the link of usages of atomic services and items within a claim but will not be use in claim rule based engine or valuation

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