BenefitScreen
This business rule controls the layout and functionality of palette Service BenefitScreen as well as OIPA Service Benefit Screen for a segment. It specifies the syntax for individual segment name and their fields. This business rule can be configured to define Benefit attributes such as coinsurance, per day allowed amount etc at the segment level for each of the services under the service groups.
Element/Tag | Attribute | Definition | Element/Attribute Value and Description |
---|---|---|---|
<BenefitScreen> |
|
Opening and Closing element for BenefitScreen. |
|
<Benefits> | |||
<Benefit> | Required and repeatable element: | ||
SEGMENTNAME | Required element: Segment name where Service Benefit is to be set up. | Segment Name | |
<Fields> | Required if Search element exists. | ||
<Search> | Optional element: By default Service Group Description and Service Description combo box will be available for search if Search element is not configured. | ||
<Field> | |||
<Group> | Allows defining the database table to retrieve values. | ServiceGroup & Service | |
<Query> | SQL | ||
<Results> | |||
<Table> | Required element: This element controls the display of the Service Benefit data table. | ||
<Column> | WIDTH | Optional element: This element defines the width of columns in the results table, the alignment of the column's data and the format of the column's data | |
ALIGN |
Left: The information in the column will be left-aligned. Right: The information in the column will be right-aligned. Center: The information in the column will be centered. |
||
<Name> | Field name | ||
<Display> | Field display name | ||
<DataType> | Data type | ||
<Group> |
Optional element: This element identifies the database table from which the requirement information should be extracted. Used to retrieve information from Service Group, Services. For example,Group>SegmentServiceBnftField</Group> indicates that the data should come from the AsSegmentServiceBnftField database table. |
SegmentServiceBnftField |
XML Schema
<BenefitScreen>
<Benefits>
<Benefit SEGMENTNAME=”[Segment Name]”>
<Search>
<Fields>
<Field>
<Name>String</Name>
<Display>String</Display>
<Group>[ServiceGroup|Service]</Group>
</Field>
</Fields>
</Search>
<Results>
<Table>
<Column WIDTH="[INTEGER]" ALIGN="[LEFT|RIGHT]">
<Name>String</Name>
<Display>String</Display>
<Group>Service|ServiceGroup</Group>
<DataType>[Availabe Data types]</DataType>
</Column>
</Table>
</Results>
<Benefit>
</Benefits>
</BenefitScreen>
XML Sample
<BenefitScreen>
<Benefits>
<Benefit SEGMENTNAME="BaseCoverageBasic">
<Search>
<Fields>
<Field>
<Name>ServiceGroupCode</Name>
<Display>Service Groups</Display>
<DataType>Combo</DataType>
<Group>ServiceGroup</Group>
<Query TYPE="SQL">SELECT '' as CodeValue, 'ALL' as ShortDescription FROM DUAL UNION SELECT distinct servicegroupcode as CodeValue, servicegroupdescription as ShortDescription FROM asservicegroup ORDER BY 2 desc</Query>
</Field>
<Field>
<Name>ServiceCode</Name>
<Display>Services</Display>
<DataType>Combo</DataType>
<Group>Service</Group>
<Query TYPE="SQL">SELECT '' as CodeValue, 'ALL' as ShortDescription FROM DUAL UNION SELECT distinct servicecode as CodeValue, servicedescription as ShortDescription FROM asservice ORDER BY 2 desc</Query>
</Field>
<Field>
<Name>ServiceDescription</Name>
<Display>Service Description</Display>
<DataType>Text</DataType>
<Group>Service</Group>
</Field>
<Field>
<Name>ServiceGroupDescription</Name>
<Display>Service Group Description</Display>
<DataType>Text</DataType>
<Group>ServiceGroup</Group>
</Field>
</Fields>
</Search>
<Results>
<Table>
<Column WIDTH="100" ALIGN="LEFT">
<Name>Covered</Name>
<Display>Covered</Display>
<DataType>Text</DataType>
<Group>SEGMENTNAMESERVICEBNFTFIELD</Group>
</Column>
<Column WIDTH="100" ALIGN="LEFT">
<Name>Copay</Name>
<Display>Copay</Display>
<DataType>Integer</DataType>
<Group>SEGMENTNAMESERVICEBNFTFIELD</Group>
</Column>
<Column WIDTH="100" ALIGN="LEFT">
<Name>CoInsurance</Name>
<Display>CoInsurance</Display>
<DataType>Integer</DataType>
<Group>SEGMENTNAMESERVICEBNFTFIELD</Group>
</Column>
<Column WIDTH="100" ALIGN="LEFT">
<Name>EffectiveDate</Name>
<Display>Effective Date</Display>
<DataType>Date</DataType>
<Group>SEGMENTNAMESERVICEBNFTFIELD</Group>
</Column>
<Column WIDTH="100" ALIGN="LEFT">
<Name>Limitations</Name>
<Display>Limitations</Display>
<DataType>Text</DataType>
<Group>SEGMENTNAMESERVICEBNFTFIELD</Group>
</Column>
</Table>
</Results>
</Benefit>
</Benefits>
</BenefitScreen>