In order to really be able to have a flexible Payment and account approach, openIMIS must address the current limitations of the data structure OpenIMIS structural limitations : New data structure required

This page will try do define the payment and account approach as is those issue are resolve but should still work with the current model

Mapping of old data model to new product model

• the product items and services in addition the limits per type of HF or care are considered as “coverage plan“

• Each product will have its own pool

• 2 PP&R (type claim payment) are considered for HF payment (fee for service and capitation), the assignment of each is based on the capitation filter, all HF not matching are considered as having the fee for service PP&R. those PP&R don’t have any Pricelists

• 1 PP&R (type contribution fees) will be considered for EO commission

• 1 PP&R (type contribution fees) will be considered for payment fees

• 1 Contribution plan will be consider per product