Payment plan calculation rule: Capitation

version = 1
status = active
UUID = 0a1b6d54-5681-4fa6-ac47-2a99c235eaa8
calculation_rule_name = “payment: capitation “

type = account_payable

sub_type = third_party_payment

dateValidTo = None

dateValidFrom = 2000-01-01

list of impacted parameters: NULL (will take data from product, claims … )

description = “ This calculation will, for the selected level and product, calculate how much the insurance need to pay the HF for the capitation financing “

Service

activeForObject(self, instance, context, type, sub_type)

instance.__class__ == PaymentPan and context IN (submit) and self.checkCalculation(instance)

check_calculation

return true (to be updated once real payment plan will be in place)

calculate(cls, instance, *args[date_from, date_to, productid, location])

instance.__class__ == PaymentPlan

get all valuated claims that should be evaluated with capitation that matches args (existing function develop in TZ scope)

create a bill through the converters from the calculation result (save the calculation result in bill notes/item details)

billCreationFromCalculation(date_from, date_to, type, sub_type, product_id, location)

Registration on signals from other module(existing or not):

• billCreationFromCalculation

Batchrun will trigger billCreationFromCalculation and will send: when the payment plan would be deliver the batch run page could be replaced by payment plan (this page could call billCreationFromCalculation service on selected payment plans) page and bill page.

if active_for_object(<fakepaymentplan>, 'submit', type, sub_type):

calculate(cls, <fakepaymentplan>, *args[date_from, date_to, productid, location])

Converter

[to be updated]

1. two way of creating the accountPayableare possible for the capitation, in both case there will be one “accountPayable” per HF

   1. one asset (line) per weighted indicator I for product P : Allocated contribution/ Sum(indicator for P) as unit price , indicator I as quantity, (1-weight) as discount;

      1. Population living in catchments area of the health facility

      2. Number of families living in catchments area of the health facility

      3. Insured population living in catchments area of the health facility

      4. Insured number of families living in catchments area of the health facility

      5. Number of claims (contacts) with the health facility by insured in the catchment area

      6. Adjusted amount

   2. asset (line) per product with the detail of the calculation as asset description