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Administration of batches of claims is restricted to users with the system role of Accountant or with a role including an access to Claims/Claim/Batch.

Pre-conditions

A claim has been already processed (review actions menu).

Navigation

All functionality for use with the administration of processing of batches can be found under the main menu Claims, sub menu Batch Run (Img. 46).

Clicking on the sub menu Batch Run re-directs the current user to the Batch Run Control Page.

Batch Run Control Page

The Batch Run Control Page is the central point for batch processing administration. Access to the page is restricted to users with the system role of Accountant or with a role including an access to Claims/Claim/Batch. By having access to this page, it is possible to process batches, filter, and filter for accounts. The panel is divided into six sections (Img. 47)

  1. Batch Processing Panel

The batch processing panel allows a user to process batches based on the following criteria:

Region

Select the Region from the list of regions by clicking on the arrow on the right of the selector to select a region. Note: The list will only be filled with the regions assigned to the current logged in user and the option National. The option National will process all the claim for the period specified in Month and Year

District

Select the district from the list of districts by clicking on the arrow on the right of the selector to select a district. Note: The list will only be filled with the districts belonging to the selected region and assigned to the current logged in user. If this is the only one then the district will be automatically selected. If no district is selected then the processing is done only for insurance product defined for the selected region.

Year

Select the Year from the list of available years by clicking on the arrow on the right of the selector. Only periods for which a batch hasn’t been run yet are offered in both lists.

Month

Select the Month from the list of months by clicking on the arrow on the right of the selector.

The Month at the end of the quarter process the claim for insuree having a product with Quaterly distribution (Product Page):

March –> Process the claim for first quatrerJune –> Process the claim for second quatrerSeptember –> Process the claim for Third quatrerDecember –> Process the claim for Fourth quatrer

December process the claim for insuree having a product with Yearly distribution (Product Page)

Process

Once criteria are chosen, clicking on this button (Img. 48), the claims will be processed based on the selected criteria. If the option National was used in the field Region, the batch will run only for nationwide insurance products. If a region is selected in the field Region and no district is selected, the batch will run only for regional insurance products for the selected region. If a district is selected in the field District the batch is run only for district insurance products for the selected district.

image-20240227-092355.png
  1. Filter Panel for the relative price index per product and period

The filter panel allows a user to filter the of indexes for relative pricing per period, product and zone (results of running of batches). In case the product doesn’t have any distribution configured then no relative price index are calculated by running the batch meaning no record will be added to the below list.

the Relative price indexes can be filtered based on the following criteria:

Type

Select the Type; from the list of time group types (Monthly, Quarterly, Yearly) by clicking on the arrow on the right of the selector.

Year

Select the Year; from the list of available years by clicking on the arrow on the right of the selector.

Period

Select the Period; from the list of months/quarters by clicking on the arrow on the right of the selector.

Region

Select the Region; from the list that appear after typing characters, all region containing the typed text will appear and be selectable underneath the box. Note: The list will only be filled with the regions assigned to the current logged in user. If this is only one then the region will be automatically selected

District

Select the District; from the list that appear after typing characters , all district containing the typed text will appear and be selectable underneath the box. Note: The list will only be filled with the districts belonging to the selected region and assigned to the current logged in user. If this is only one then the district will be automatically selected

Product

Select the Product; from the list that appear after typing characters , all product containing the typed text will appear and be selectable underneath the box.

Category

Select category of health care (In-patient/hospital, Out-patient/Non-hospital, All) from the list of categories of health care by clicking on the arrow on the right of the selector.

Filter

Once criteria are chosen, clicking on this filter button (Img. 49) will filter based on the selection criteria.

image-20240227-092523.png
  1. Display Panel for the relative price index per product and period

The Display Panel is used to display results of running of batches after the filter or processing.

  1. Filter for Accounts Panel

The Filter for Accounts Panel is used in filtering of batch protocols for an accounting system based on the following criteria:

Group By

Select either grouping of the report by health facility (health facility) or by product (Product).

Start Date

Type in a date; or use the Date Selector (Tab. 12) to enter date which is equal or less than claim date. Note. To clear the date entry box; use the ``Clear`` button on the date picker popup.

End Date

Type in a date; or use the Date Selector (Tab. 12) to enter date which is equal or greater than claim date. Note. To clear the date entry box; use the ``Clear`` button on the date picker popup.

Show Claims

Check this checkbox, if you need to show all claims in detailed way in the protocol.

Region

Select the Region; from the list that appear after typing characters, all region containing the typed text will appear and be selectable underneath the box. Note: The list will only be filled with the regions assigned to the current logged in user. If this is only one then the region will be automatically selected

District

Select the District; from the list that appear after typing characters , all district containing the typed text will appear and be selectable underneath the box. Note: The list will only be filled with the districts belonging to the selected region and assigned to the current logged in user. If this is only one then the district will be automatically selected

Health facility

Select the Health facility; from the list that appear after typing characters, all Health facility containing the typed text will appear and be selectable underneath the box.*Note: The list will only be filled with the Health facility belonging to the selected region and assigned to the current logged in user. If this is only one then the Health facility will be automatically selected*

Product

Select the Product; from the list that appear after typing characters , all product containing the typed text will appear and be selectable underneath the box.

Health facility Level

Select a level from the list of levels of health facilities by clicking on the arrow on the right of the selector.

Show All

Check this checkbox, if you need to show all health facilities in the report although they have no claim included.

Preview

Once criteria are chosen, clicking on this preview button (Img. 50) will create a protocol of the selected batch.

image-20240227-092715.png
  1. Button Panel

This panel contains control button.

Back

By clicking on the back button (Img. 14), the user will be re-directed to the Home Page.

  1. Information Panel

The Information Panel is used to display messages back to the user. Messages will occur once a batch has been processed, filtered or if there was an error at any time during the process of these actions.



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