Benefits, Services, and Fees Catalog

Definition

Directory of benefits or services and associated fees, comprising benefit catalog items

Use

You can use benefits, services, and fees catalogs (referred to hereafter simply as benefit catalogs) for processing claims, for example in the areas of health insurance, accident insurance, or Workers Compensation.

You have the following options for making a benefit catalog available to the Claims Management system:

You can load the data of external benefit catalogs directly via direct input, and change this data if necessary.

For more information, see Creating a Benefit Catalog Item via Direct Input .
You can create benefit catalogs t o suit your own purposes.

Structure

Benefit Catalog Variants

You can define variants for each benefit catalog . In maintenance of benefit catalog items, you can then give different characteristics to the individual benefit catalog items of each variant.

You define the possible variants in Customizing activity Define Business Catalog Variants .

Versioning

In contrast to the individual benefit catalog items, there is no versioning with benefit catalogs. This means that if you want to create a new version of a benefit catalog, you have to create the benefit catalog with a new ID.

Integration

To assign benefits, services, and fees catalogs to an internal claim type, you can also use the cross-application component called Classification System . For more information, see Integration of Classification System with SAP Claims Management .

Example

Examples of catalogs in the area of health insurance :

GOÄ – Physician fee catalog (in Germany)
PZN – Pharmaceutical central number catalog (in Germany)

Examples of catalogs in the area of accident insurance :

VERL – Injury money catalog

Here you can specify intervals (from/to values) for the evaluation quantity, for example.