Description
The program evaluates billing information and supplies the datanecessary for the German disproportionate share adjustment (accordingto §267 SGB).
For each insurance provider and accounting period (quarter) the totalof the invoiced amounts is displayed for each status of insured.Possible copayments are not included.

Precondition
The data survey is only necessary for the statutory health insurancefunds and that is why the evaluation should be limited by means of theinsurance provider type.

Selection parameters
By means of the selection parameters, the program can be limited tocertain insurance types or insurance providers. You can also do thisvia the invoice date.
You can also choose to limit the evaluation to a certain quarter ('onlyfor quarter'), by specifying a quarter. In this case, please respectthe format 'YYYYQQ', for example 199401 for the 1st quarter of 1994. Ifyou do not specify a quarter, the system determines the respectivequarter automatically for all selected invoices.
By means of a number of further options you can specify

• Whether the output is to be normal (standard) or enhanced


• Ehether the amounts for each status of the insured person are to be
totalled via the case types in the selection (standard) or not

• Whether the amounts for each identical status of the insured person are
to be totalled (standard), or are to be displayed separately for everysingle invoice of a case (caution: size of the list!). Note thatamounts are always posted separately for patients with an empty statusof the insured person.

• Whether the end date of the invoice line items or the invoice date is
to be used for assignment to the calculation period (standard). In thefirst case, the end date of the last invoive line item is used forquarter assignment.

• Whether cases with missing status of the insured person are to be
considered (standard) or not. If this is the case, every case withempty status is then displayed in a separate line.

Output
The data can be printed as a data entry form, or output in a file.
Printout:
If an enhanced log is requested, a list of the affected cases and theinvoices is created in addition to the data entry form data. This listhas the following structure:


• Case number


• Patient name


• Insurance provider type


• Insurance provider number


• Status of insured (five-digit)


• Invoice amount


• Relevant date calculation period


• Document number of the invoice.

You can replace the default printout of the data entry form by your ownprint formatting routines to which you can refer at the program start(please set 'next page' selection parameter).
As regards sorting, you can use functions you have created yourself fora general page header and for the data of the data entry form.
You can use the routines

• Form TOP-OF-PAGE


• Form SORT and


• Form DATA ENTRY FORM

of program RNL267DR as references. Please do not change programRNL267DR but only copy it if required.
File output:
The selection screen (2nd page) also allows you to output data into afile Two different methods are available: you can either output thefile on the application server or on the local presentation server. Youhave to enter a file name (including path) and the recipient of thefile to do this. In this case, the file format corresponds to the fileformat prescribed in the outline agreements for §267 SGB. To ensurecorrect file contents, you must make settings on the selection screenin such a way that the amounts for each status of insured are outputand cases without status of insured are not taken into account .

Notes


• An apparently incorrect report of several lines repeating the same
combination of insurance provider, quarter and status can then occur ifdifferent health insurance numbers (institute indicator numbers) havebeen entered or imported for the same insurance provider.

• If an invoice is cancelled for a period for which this evaluation has
already been carried out, this is not settled with the values of asubsequent quarter. However, the evaluation can be carried outrepeatedly for the period in question.

• If you carry out billing for several quarters, the invoice is added to
the later quarter. The amounts are not divided among the differentquarters.