SAP Program RNLLST02 - IS-H: Case/Service Evaluation for Outpatient Cases

Description
This program determines outpatient cases for which services exist. Youcan specify either the visit date, the case numbers or a case selectionas selection criteria. In addition to the service, service daterequesting and performing organizational units, you must specify thefollowing attributes for service delimitation:

  • Billable services

  • Non-billable "

  • Canceled "

  • Not canceled "

  • Service status: planned

  • performed (actual)
    The country versions Singapore and Switzerland contain the additionalselection option class of a service. The class of a service isderived from the class of the movement to which it is assigned. If aservice is not assigned to a movement, the system searches for anappropriate movement.
    Billing status as a selection criterion
    In the Billing status group box, you can specify to what extentthe billing status of a service is to be used to select services. If youdo not want the billing status to be used as a selection criterion,select Do not take into account. In the contrary case, selectTake into account and select at least one of the three billingstatuses (completely, partially and not billed).
    Please note that the status Partially billed is not available inall country versions (it is not available in the Singapore countryversion, for example).
    Definitions
    A service is completely billed for if it was billed for for thecomplete period and to all relevant insurance providers, i.e. there areno outstanding invoices.
    A service is partially billed if it was billed for for only forpart of a period, or only to some but not all the relevant insuranceproviders.
    A service is not billed for if an invoice has not been createdfor this service.
    Evaluation options
    You can create evaluations in relation to the billing status of thecases and consequently answer a variety of questions. To do this, underthe group heading Billing status select Take into accountand the required billing status. You can select any combination ofbilling statuses.
    Here are number of examples:
    • Evaluate cases for which services exist that still have to be billed for

    • Select Not billed and Partially billed. Since there are nooutstanding invoices for completely billed services, you must notselect this option.
      Non-billable services are not relevant for this evaluation, since youare not required to create invoices for them. You should consequentlyexclude non-billable services from the evaluation by deselectingNon-billable and Cases without billable services only.
      To evaluate only services that are billable and already billed for,exclude planned services from the evaluation. To do this, deselectPlanned (pl.), if necessary.
      • Evaluation of cases with services for which invoices have already been
      • created.
        Select Completely billed and Partially billed. Invoices donot yet exist for services that are Not billed for. You musttherefore not select this option.
        • Evaluation of cases with services that have only been partially billed
        • for.
          Select Partially billed. Not billed services have not yetbeen processed (as regards billing) and Completely billedservices have already been dealt with. Consequently, you must not selecteither of these options.
          Note: If you select either Completely billed or Partiallybilled, you should reckon with extensive runtimes.
          The program allows you to make a great many restrictions on theevaluation. However, not all combinations are expedient or possible. Theprogram performs different plausibility checks and issues appropriatewarnings or error messages.
          You can write all of the cases that are determined in the case/serviceevaluation to a case selection. To do this, select Append CaseSelection, and specify an existing or new case selection in theadjacent field. If the case selection already exists, the casesevaluated in the program run are added to it. In the contrary case, theprogram creates the case selection.

          Functions of Data source... Pushbutton
          To avoid long run times each time the report is called, you can useData source.. to save the selected report data in an extract. Forfurther information about this, see Workingwith Report Extracts.

          Output
          The program outputs a list of cases for which you can display theservices. The billing status of a case is represented by the iconsbeneath Status. The icons have the following meaning:

          • Empty square: case has not yet been billed

          • Half-filled square: case is partially billed

          • Filled square: case has been completely billed

          • For each service, the system outputs whether the service appears in (atleast) one invoice (column Bld) and the latest date by which itmust be billed for by (can also be for part of service only) (column (
            Max. to).