Payment Plans (User Manual)

Owned by Thea Minnich
Last updated: May 24, 2024
8 min read

Content

Payment plans is responsible for generating bills.

Pre-conditions

In order to create a payment plan there must be at least one product needs to be created.

Ones a product is available navigate to the Payment Plans under Legal and Finance menu

 

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Img. 182 Navigate to Payment plans menu

All the existing payment plans can be found here.

 

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Img. 183 Payment plans

Search Panel

Code

Enter a code to filter the payment plans

Name

Enter the full name or the part of the name to filter the payment plans

Calculation resultpanel

Select a calculation rule by clicking on the righ arrow in the dropdown. Here are the possible choices.

  • Payment: Fee for Service (Payment plans for fee for service)

  • Payment: Capitation (Payment plans for capitation)

  • Payment: Commission (Payment plans for commission)

  • Payment: Fees (Payment plans for fees)

  • Payment: Unconditional Cash Payment (Payment plans for unconditional cash payment)

Benefit product

Select a product from the dropdown list by clikcing on the right arrow.

Periodicity

This field represents a number of months a payment plan needs to be executed.

Valid from

Use the date selector to enter the Valid from to search for payment plans with a Valid from date equal or later than the specified date.

Valid to

Use the date selector to enter the Valid to to search for payment plans with a Valid to date equal or earlier than the specified date.

Show Deleted

By clicking this checkbox a user can list all the deleted payment plans along with the valid ones.

Create new Payment Plan

To create a new payment plan click on the Add (+) icon in the bottom right of the page.

 

This will open up the following form to enter the payment plan deatils

 

Code

Enter a unique code for the payment plan. Mandatory

Name

Enter a name for the payment plan. Mandatory

Calculation Rule

Select a calculation rule from the dropdown list by clicking on the arrow on the right hand side. Here are the possible choices. Mandatory

  • Payment: Fee for Service (Payment plans for fee for service)

  • Payment: Capitation (Payment plans for capitation)

  • Payment: Commission (Payment plans for commission)

  • Payment: Fees (Payment plans for fees)

  • Payment: Unconditional Cash Payment (Payment plans for unconditional cash payment)

Benefit Product

Select a product from the dropdown list by clicking on the arrow on the right hand side. Mandatory

Periodicity

Enter the periodicity in terms of months. This means how often do you want to generate bills for the payment plans. For instance, entering 1 will generate a bill every month. Mandatory

Valid from

Use the date selector to enter the Valid from. This indicates from which date this payment plan comes in effect. Mandatory

Valid to

Use the date selector to enter the Valid to. This indicates until which date this payment plan is valid.

Additional parameters

Additional parameters change based on the calculation rule selected.

  • Payment: Fee for Service

Claim Type
Here you can select for which claims this payment plan is valid. The options are All, Hospital/In-patient and None-hospital/Out-patient

Level 1
Here a user can define the first level. Options are Hospital, Dispensary and Health center.

Sublevel 1
Here a user can define the first sublevel. Options are District and Region

Level 2
Here a user can define the second level. Options are Hospital, Dispensary and Health center.

Sublevel 2
Here a user can define the second sublevel. Options are District and Region

Level 3
Here a user can define the third level. Options are Hospital, Dispensary and Health center.

Sublevel 3
Here a user can define the third sublevel. Options are District and Region

Level 4
Here a user can define the fourth level. Options are Hospital, Dispensary and Health center.

Sublevel 4
Here a user can define the fourth sublevel. Options are District and Region

  • Payment: Capitation

    Claim Type
    Here you can select for which claims this payment plan is valid. The options are All, Hospital/In-patient and None-hospital/Out-patient
    Level 1
    Here a user can define the first level. Options are Hospital, Dispensary and Health center.
    Sublevel 1
    Here a user can define the first sublevel. Options are District and Region
    Level 2
    Here a user can define the second level. Options are Hospital, Dispensary and Health center.
    Sublevel 2
    Here a user can define the second sublevel. Options are payment_newDistrict and Region
    Level 3
    Here a user can define the third level. Options are Hospital, Dispensary and Health center.
    Sublevel 3
    Here a user can define the third sublevel. Options are District and Region
    Level 4
    Here a user can define the fourth level. Options are Hospital, Dispensary and Health center.
    Sublevel 4
    Here a user can define the fourth sublevel. Options are District and Region
    Share Contribution
    Enter the valid integer from 0 to 100 to define the percentage (%) of the share of allocated contribution for given insurance product and the period specified. payment_newentage (%) of the numner of insured population by given insurance product and living in the catchment area of the individual health facility.
    Weight number insured families
    Enter the valid integer from 0 to 100 to define the percentage (%) of the numner of insured families by given insurance product and living in the catchment area of the individual health facility.
    Weight number visits
    Enter the valid integer from 0 to 100 to define the percentage (%) of the number of contacts of insured by given insurace product and living in the catchment area of the individual health facility.
    Weight amount adjusted
    Enter the valid integer from 0 to 100 to define the percentage (%) of the adjusted amount on claims for insured by given insurance product and living in the catchment area of the individual health facility.

The capitation formula is defined as follow:

Where

  • CapitationPayment𝑖 is the amount of capitation payment for i-th health facility

  • Indicator𝑖𝑎 is the value of the indicator of the type a for the i-th health facility.

  • Indicator𝑖𝑎 may be:

    • Population living in catchments area of the health payment_newfacility

    • Number of families living in catchments area of the health facility

    • Insured population living in catchments area of the health facility

    • Insured number of families living in catchments area of the health facility

    • Numbpayment_new of claims (contacts) with the health facility by insured in the catchment area

    • Adjusted amount

  • AllocatedContribution is the amount of contributions for given insurance product for given period

  • ShareContribution is the formula parameter Share of contribution

  • Share𝑎 is the weight of the indicator of the type a .

  • Share𝑎 may be:

    • Weight of Population

    • Weight of Number of Families

    • Weight of Insured Population

    • Weight of Number of Insured Families

    • Weight of Number of Visits

    • Weight of Adjusted Amount

  • Payment: Commission

    Commission Rate(%)
    Enter the valid number to define the percentage to be paid.

  • Payment: Fees

    Fee rate(%)

    This is the total percentage of the amount needs to be paid.

    Payment origin

    Enter the name of the origin of the payment. For instance, if the name of the payment gateway is ABC then the value should be ABC in this field.

 

  • Payment: Unconditional cash payment

    Lumpsum to be paid
    Enter a valid number to be paid as a lumpsum amount
    Invoice label
    Enter the label of the invoice to which the lumpsum amount applies
    Ones all the the mandatory fields are entered, click on the SAVE button in the bottom right of the page. The user will be redirected to the Payment plans page with the newly created record displayed and selected in the result panel.

Result Panel

Click on the new version menu icon on the payment plan you want to create a new version. This will open the selected payment plan in an edit mode. Make the necessary changes and click on the save button. This will create a new record in the system with the changes applied. A user will be redirected to the previous page and a new version of the payment plan will be displayed in the result panel. This will also inactive the previous record.

  • Edit

    Click on the pencil icon on the payment plan you want edit. This will open the selected payment plan in edit mode.

    A user can modify the payment plan and then click on the save button at the bottom right of the page to save the changes.

  • Delete

    Click on the trash icon on the payment plan you want to delete. This will open up a confirmation dialog.


    Confirm the action by clicking on the OK button and this will delete the payment plan. A user can click on the CANCEL button to abort the operation.

 

EN

Payment Plans

FR

 

 

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