Healthcare Starter Pack

Overview

This documentation lists all scenarios defined in the Healthcare starter pack. To use a starter pack, ensure that you have already completed the steps in Use a starter pack.

Test scenarios

Test scenariosAvailable service typeDescription
Upload health product and health plan
  • API
  • Batch

Creates a health product and plan using API and processes it with batch execution.

  • Product code — code of the health product that will be used when creating a customer.
  • Plan code — code of the health plan that will be used when creating a customer.
  • Batch-C1-HCPHP — batch that processes the inbound messages for the creation of health products or plans.
Rate upload

  • API
  • Batch

Creates rates that define customer's charges and billable charges.

  • Batch-C1-HCPHP — batch that processes the inbound messages for the creation of rates.
Custmomer upload by referring rate plans
  • API
  • Batch

Updates a customer account based on product code, plan code, and rate. For example, if a rate is specified with Tobacco is Y and a customer has a Y Tobacco switch, then the rate will be mapped to the customer.

Runs the Batch - C1-HCEXS to process the inbound bound message for the creation of the customer, account, and contract.

Billable charge creation

  • Batch

Runs the following batches in order:

  • C1-REPC1 (Identify Entities for Repricing) — Identifies the entities that are eligible for repricing.
  • C1-REPC2 (Process Repricing Request) — Processes the entities captured by the C1-REPC1 batch.
  • C1-FIBCR (Fully Insured Billable Charge Creation) — Creates the billable charge for the processed entities.
Customer billing
  • Batch
  • UI

Generates a bill using the billable charges and account. For batch testing, it runs the following batches in order:

  • BILLOPEN (Pending Bill Generation) — Generates a blank bill in pending status for accounts in the specified division and bill cycle based on the given cut-off date.
  • BSGENREG (Bill Segment Generation) —Generates bill segments, including all billable charges, of accounts that have blank bills in an open bill cycle, input bill cycle, or division for a given cutoff date.
  • POSTPROC (Bill Completion) — Creates a post-processing bill segment generated by previous batches and finalizes the bill.
General ledger scenario
  • Batch

Runs the following batches in order:

  • C1-GLASGN — Assigns the General Ledger account to a financial transaction.
  • GLS — Stages the downloaded General Ledger.
  • GLDL — Extracts the downloaded General Ledger.
Create payment
  • API
Creates a payment for the generated bill.