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

from_to: [{“from”:”BatchRun”,”to”:”Bill”}]

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)

check_calculation

if HF → locations

if location → ProductS (Product also related to Region if the location is a district)

if product → paymentPlans

if paymentPlan → check if UUID = this.UUID

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

if context == “batchPayment“

elseif context == “batchValuation“

elseif context == “individualPayment“

elseif context == “individualValuation“

convert(from, to, **argv)

if context == “batchPayment“

argv

• product_id

• batch_id

• sub_type,

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

[to be updated]

1. [out of scope]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

bill:

billItem