Service Check with Respect to Absences (R9) (SAP Library

Service Check with Respect to Absences (R9)

Use

The rule type Service Check with Respect to Absences (R9) contains predefined checks that verify if, when absences exist for a case, the validity intervals of extended services entered are delimited in accordance with the absences. If you have defined an absence service in Customizing for IS-H, the system also checks if an absence service exists for the duration of the absence.

Features

If the system detects a rule violation, it issues a corresponding message. You can define the type of this message in Customizing for IS-H. This rule type also supports service actions, thereby allowing you to have the system automatically correct errors in service entry. In such cases, the system takes into account the settings you made in Customizing for IS-H for the billability of the absence start day or absence end day.

For information about the Customizing settings for this rule type, see SAP Healthcare – Industry-Specific Components for Hospitals ® Patient Accounting ® Service Rules in the IS-H Implementation Guide.

The system supports service actions for the following rule violations:

An extended service to be delimited exists in the absence interval

If an extended service exists for a case in the absence interval, the system detects a rule violation. By way of a service action, the system proposes to adjust the service for the absence as follows:

If you created the start and end of the absence with the status Actual, the system sets the valid to date of the existing service records to the absence start date. For the period of hospitalization following the absence, the system creates new service records for the delimited services that are valid from the absence end date.

If you created the start of absence with the status Planned and/or the end of absence with the status Planned, the system does not adjust the existing extended services for the absence. Only when you save the start and end of absence with the status Actual does the system delimit the validity of the services in accordance with the absence and create the absence service for the duration of the absence.

An absence service exists outside of the absence interval

If an absence service is entered for a case and it is valid outside of the absence interval, or if an absence service is entered when an absence does not exist, the system detects a rule violation. By way of a service action, the system proposes to cancel the absence service.

The validity interval of the absence service does not match the absence interval.

If the validity interval of the absence service is partially outside the absence interval, the system detects a rule violation. By way of a service adjustment action, the system proposes to set the valid to date of the absence service to the absence end date.

An absence exists without an absence service

If an absence exists for a case and, although an absence service is defined in Customizing for IS-H, you haven’t entered this service for the absence interval, the system detects a rule violation. By way of a service action, the system proposes to create the absence service for the absence interval.

Delimited extended services exist and the absence is canceled

If a canceled absence exists, the system performs the following two checks for the rule type R9:

Do extended services exist whose validity has been aligned on the start and end of the absence?

Did the system automatically align the validity of these services (either by means of service adjustment actions of the rule type R9 or by means of the program for adjusting services for absences RNAABW00) on the absence?

Only if the result of both of these checks is positive does the system detect a rule violation. By way of a service adjustment action, the system proposes to create the delimited extended service for the canceled absence interval.

Note

This service adjustment action mainly concerns personal items. If the case nursing charge or departmental per diem is missing after an absence has been canceled, the system also detects this on the basis of the checks of the rule type R5. By way of a service action the system proposes to create the services for the days in question. Consequently, if configured accordingly, the system can also fully create the base nursing charge and departmental per diem, if you have not carried out service adjustment using service actions of the rule type R9 or using the program for adjusting extended services for absences (program RNAABW00).

For this reason, in IS-H Customizing, you should have activated the rule type R5 for the same check points as you did the rule type R9. Note in this case, that the system first executes the rule type R9 then the rule type R5 at a check point. You can define the order in which the system is to execute the service rule checks by specifying the appropriate rank in the check procedure. For information about activating rule types in the check procedure, see SAP Healthcare – Industry-Specific Components for Hospital ® Patient Accounting ® Service Rules ® Maintain Check Procedure in the IS-H Implementation Guide.

Caution

If you manually adjusted extended services, with the exception of the base nursing charge and the departmental per diem (see above), with regard to an absence interval and subsequently canceled the service, the system does not automatically extend the validity interval of these services. The system does not issue a message to inform you of possible gaps in charges.

The service checks and service actions of this rule type are supported in the following functions:

Service Entry
Create/Change Absence
Billing

Note, however, that services are not adjusted for the absence in the following situations:

If you subsequently change the time the absence starts or ends, the system only adjusts the services concerned on the basis of the changed time, if the quantity of billable services is modified by this time change.

If you shorten an absence, the system extends the validity intervals of the base nursing charge and of the departmental per diem on the basis of the service adjustment rule of the rule type R5, and in this way adjusts these services for the changed absence. Other extended services, such as personal items, are not adjusted automatically. The system does not issue a message to inform you of possible missing services. If these services were performed for the case, you must created them manually for the days in question.

If you subsequently change the start or end of the absence and this change affects services that have already been billed for, the system issues a warning. You can save the changed absence, however the services concerned are not adjusted on the basis of this change.