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Background documentationRole-Based Performer in Claim Bundle

 

When processing claim bundles, you can use the functions of role-based performer to assign performers. The function “role-based performer in claim bundle” is almost the same as the function “role-based performer in claim”. The documentation Role-Based Performer (RBP), including its sub-sections, is therefore also valid for role-based performer in the claim bundle, but with the restrictions mentioned below.

The function “role-based performer in claim bundle” has the following restrictions compared with the function “role-based performer in claim”:

  • With automatic performer assignment, only late assignment is possible in the claim bundle. Early assignment is not supported. For more information, see Automatic Performer Assignment.

  • A mass change of performer assignment is not supported in the claim bundle. For more information, see Mass Change of Performer Assignment.

  • If you change performer data in the claim bundle, this changed data is not replicated to the claims that belong to the claim bundle.

  • Changes to performer assignment in direct input are not supported.

  • In the claim search (transaction ICLEXPERT), you can use certain data of role-based performer as search criteria (such as the role of the performer). This is not possible in the claim bundle search (transaction ICLEEXPERT).

Caution Caution

SAP only provides a sample implementation for claim bundles in the category of Multiple Contract Handling. If you want to use role-based performer for other claim bundle categories, then you will have to enhance your coding accordingly.

End of the caution.

Prerequisites

  • You have activated the Business Function INS_FSCM_MULT_CONTR_1 (Insurance Claim Multiple Contract Handling).

  • You have performed the Customizing activities under Start of the navigation path Claims Management Next navigation step Claim Bundle Next navigation step Business Settings Next navigation step Role-Based Performer End of the navigation path.

    In particular, take note of the documentation for Customizing activity Use Role-Based Performer in Claim Bundle.

  • You have made the required Customizing settings for the dummy claim.

  • You have included screen ICLRP1 in your screen sequence.

Features

In claim bundle processing, the following functions are available on the Performer Overview tab page:

  • You can assign a performer in a certain performer role to the claim bundle and also change the assignment.

    If the Mandatory checkbox is selected for a performer role, you must enter a performer for this role.

    Note Note

    In Customizing activity Configure Role Profiles (Customizing path - see “Prerequisites” above), you define at the level of RBP: Assignment Role -> Profile for each performer role whether entry of a performer is mandatory.

    End of the note.
  • You can also view a history of the performer assignments made to date in the claim bundle. The documentation Display of Assignment History for the claim is also valid for the claim bundle.

  • You can view a history of all performers assigned to the claim bundle to date. The documentation Display of Performer History for the claim is also valid for the claim bundle.