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Manage Invoicing Rules

Explanation​

The E-Care solution was conceptualized with the principle of Invoicing Rules at its core.

An invoicing rule is the logic defining how a Service should be invoiced. The available controllers are multiple, let's mention some example: for which beneficiary kind, where to check for information, the minimum of absence to be reached so that they are considered, or how the quantity should be calculated, which service to invoice at what price, where to retrieve the information to be billed...

Create an Invoicing Rule​

To create an Invoicing Rule, use Tell me and search for Contact, select Contacts of type Lists, and then on the navigation bar select + New. Fill out the basic information about your beneficiary (name, address...). Then, on the Navigation bar select Process | Beneficiary. This will not only generate the beneficiary but also a Customer. You also find this action under Actions | Functions | Create as | Other | Beneficiary.

A Customer Template can be applied, in priority the one defined on the institution card, otherwise the one of the e-Care General Setup will be used.

From the E-Care Navigation bar, select Beneficiaries List , open your beneficiary and fill out the necessary fields.

  • Define a rule number and a description
  • Define the beneficiary kind
  • Define the Invoice Context
  • Define the invoicing source
  • Set an active start date
  • Activate the rule for your institution

See Configure an Invoicing Rule below.

Configure an Invoicing Rule​

Just create a new Rule, give it a code and a dscription and sets the fields as desired. More information about relevant fields:

Fields
> Kind of Invoicing Code : Not used
> Beneficiary Kind Code : sets the beneficiary kind for relevant for this rule
> invoicing Source : sets where to get the information for this rule
Options
- Beneficiary : not used
- Stay : specify to search information in the Stays
- Attendance : specify to search information in the Manual entries
- Evaluation : specify to search information in the Evaluations
- Absence : specify to search information in the Absences
- Institution : not used
- Contract : specify to search information in the Contracts
- TcPos : specify to search information in the Gastro
- CareCoach : specify to search information in the Ambulatory
- Spitex : not used
> Object Type Code : sets the object type (room) for this rule. If the rule must consider rooms, ptu the correct object type on it or you'll get wrong pricing.
> Service Group Code : sets the service group (related services) for this rule
> Consider Absence From Nb Days : Absences below this won't be considered for refund
> Description Method : sets how the description should be managed
Options
- Service : use description from the Service or Service Text and language support
- Manual : use description as entered on the line (usage on Contract and Man.Entry)
- Specific : use description flagged under Service Text | Specific
> Quantity Calculation Method :
Options
- None : no quantities/days calculation will occur
- Manual : use quantity as entered on the line (usage on Contract and Man.Entry)
- Days : sum the number of days in the period
- Days-Absence : sum the number of days and sum the number of absences in to period
- Absence : sum only the number of absences in the period
- Days Effective : Sum only the number of presence days in the period
> Negative Amount Sign : should change the sign for negative amount
> Price Calculation Method :
Options
- Service : find price from the Service Price according to constraints like start date, beneficiary kind
- Manual : use price as entered on the line (usage on Contract and Man.Entry)
> Time Horizon to Consider :
Options
- empty : don't consider a time horizon
- In Advance : use only upcoming period to invoice services
- Subsequent : use only past periods to invoice services
- All : use the entire period to invoice services
> Date Calculation Per : sets how should the days benn calculated
Options
- empty : don't consider a date calculation
- Contract Start Date : use the Contract Start Date to atart the sum of days
- Entry Date : use the Entry Date to atart the sum of days
- Contract Start to Entry Start : sum the days between Contract Start and Entry Date
- Leaving Date to Contract End : sum the days between Leaving Date and - Contract End Date
> Active From : sets the activation date of this rule
> Inactive From : sets the deactivation date for this rule
> Rule Invoice Context : sets the Context to invoice for this rule
> No Correction : this rule won't trigger any correction
> Absence Start on Full Day : if you start an absence from today, it will consider today as present and calculate from tomorrow
> Absence End On Full Day : if you end an absence today, it will consider today as absent and calculate presence from tomorrow
> Linked Rules No. : indicates the number of liked rules. See below
> Line Amount rounding Precision: sets the rounding precision for a settlement line
> Manual Correction : sets if this rule can be use on the Manual Entry check with dev??
tip

Avoid modifying existing Rules, as they work, you risk disrupting what is running, always prefer to create a new one, test/adjust it and then, decide to disable the older one.

caution

Don't forget not only to activate the Rule with the Active From date field, but also to activate the Rule for your institution in the Invoicing Rules by Institution matrix. To learn more about the matrix, read this.

Linked Rules Explained​

a Linked Rule is a rule that will create the SAME settlement entry as the parent rule but with the ability to switch the Context and set an operation to reverse the sign.

The common usage is for the Care billing, the system calculates the care for the Beneficiary Context, and the same value should be deducted from the Insurance Context and the Public Authority Context. So the rule with the Beneficiary Context will have 2 Linked Rules wiht the operation field set to - (negative).

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