The goal of this page is to define the narrative description of the main openimis modules:

Individual:

Minimal representation of a person that is reference in the system

flat documents can be attached to individual

Should be possible to elevate this to “client“/”insuree”

Beneficiary/Client/Insuree:

representation of a person that hold enough information to be eligible for service

Benefit Plan/Program

Definition of the benefits a person or a group of person will get once enrolled

Policy/Benefit package

Instantiation of a Benefit plan for one person or for a group of person

Coverage

Status of the Benefit package utilization

Payment plan

definition of the rule use to define payment specificities for a given benefit plan and recipient

Payment Cycle/Batch run

Accountancy run over a given period to generate the invoice to be generated using payment plan

Payment point:

API or Location used to give the payment to Beneficiary/Client/Insuree:

Payroll:

Aggregation of invoice on payment point

Claim:

request to get a benefit part of the person coverage, not every benefit need to be claimed

Voucher

for Beneficiary/Client/Insuree: prepayment for either a service or a benefit plan

for partner organization:

• can buy voucher via a Order/Contract/Notification

• can claim the reimbursement of the voucher against a proof of the benefit was provided