Maintain Payments
Application component: Claims Management
App type: Transactional
Line of business: Operations
Leading industry: Insurance
Solution capability: Claims Notification (S/4)|Claims Processing (S/4)
Description:  With this app, you can create, reverse, refund and delete payments related to claims.  
Maintain Payments related to Claims
Key features: This app provides the following key features:  Search Criteria You can search for existing payment items based on the following information:  Claim number  Payment type Depending on the search result, the system will display the payment item(s) in the form of a list report.  Create Payment To create a new payment, click on the Create button on the search screen. On the subsequent screen, enter general information like:  Payment record type  Claim number Subclaim Total amount Currency Note To flag the last payment within a subclaim as the final payment, check the Final Payment box in the Payment Overview section and close the subclaim.To create the new payment line item, enter payment details like:  Service start  Service end Posting date Net due date Payment method Payee Purpose Then click on Create. At header level of the Payment Item section, enter information like:  Claim payment item  Belongs to Amount category Payment amount Benefit type If Tax is applicable to the claim item, enter the  Tax Detail, and click on Apply to add the payment item. Choose an appropriate Payment Processing Category for the payment if applicable. To create payment for the item(s) you have added, click on Create. The system will now post the claims item(s) you have created and display the Compensation Calculation Summary and Compensation Calculation Result for the payment items that you just posted. Note   The Payment Process Category determines how you want to process Limits and Deductibles in a payment item. For example, limits or deductibles are applicable for the payment line item and you want to allow creation of a payment that is above the limit or you do not want to apply a deductible.  You can also review the Compensation Calculation Summary and Compensation Calculation Result prior to posting. To view, click on the Load Compensation Calculation Result pushbutton in the top right corner of the screen.    Park Payment If you want to enter a payment but do not have the complete information, you can select the Parked checkbox for this payment. The payment will then be parked in Claims Management and not be posted in the Collections and Disbursements system. You can still edit the payment details of the parked payments, such as the payment amount and the payee. Once you have received all the required information, you can deselect the Parked checkbox. The payment will then be posted in the Collections and Disbursements system and subsequently be paid out.  Reverse Payment  To reverse a payment, proceed as follows. In the list report, select the payment item that you would like to reverse and click on Reverse Payment. The system will then reverse the payment for the item you have chosen.Note You can only reverse a payment if the payment has not yet left the company. The system checks whether the associated document in the Collections/Disbursements system has been cleared.  Note You can also reverse a payment directly from the start screen immediately after posting payment item(s). To do so, click on the Reverse Payment button in the top right corner of the screen.  Refund Payment To refund a payment, click on the Create button in the list report. On the subsequent screen, select Refund as Payment Record Type and enter general information like:  Claim number  Subclaim Requested amount Total amount Currency Then enter payment details like:  Posting date  Net due date Payment method Payer Check number Purpose  Click on Create and on the subsequent screen, enter information on the payment items like:  Payment item  Belongs to Amount requested Benefit type If applicable, choose the tax information and click on Apply to add the payment item. You can now view the newly added refund payment item. To create a refund, click on Create. Note To navigate back to the previous screen, use the back button in the upper left corner.   Delete Payments To delete a payment item, select the item in the list report and click on Delete. Note You can only delete payments that have one of the following statuses:  New  Created   Rejected    Show Details To view the details of all payment items on a single screen, click on Show Details. To return to the previous view, click on Hide Details.Note To show more information on the details screen, select the relevant columns by clicking on Settings. 
Business roles: Insurance Claims Handler
Insurance Claims Handler : 
Processes insurance claims by capturing and investigating the circumstances of the loss and ensuring fair settlement of valid claims. Is responsible for adjudicating claims in a timely manner and maintaining high levels of customer satisfaction.