SAP Function BAPI_PATCASE_GETCLAIM - IS-H BAPI PatientCase.GetClaim - Display Invoice Data

Parameter Reference Type Length Default Optional Text
INSTITUTION BAPINALL-INSTITUTION C 4 Institution
INSURANCE_PROVIDER BAPI1309INS_PROVIDER-INS_PROVIDER C 10 X IS-H: Insurance provider
INS_PROVIDER_TYPE BAPI1309INS_PROVIDER_TYPE-IP_CATEGORY C 2 X IS-H: Internal Insurance Provider Category
PATCASEID BAPINALL-PATCASEID C 10 Case Number
TESTRUN BAPINALL-TESTRUN C 1 SPACE X IS-H: Test Run Without Database Changes (Checkbox)

Parameter Reference Type Length Text
ADMISSION_DATA BAPI2097IAOUT u 1718 IS-H BAPI Case Inpatient Admission Return Data
PATIENT_DATA BAPI1084OUT u 1193 IS-H BAPI Patient Return Data
REF_HOSPITAL_DATA BAPI1309BPARTNER u 461 IS-H BAPI Business Partner - Hospital Data
WORST_RETURNED_MSGTY BAPINALL-WORSTRETMSG C 1 Most Severe Message Type

Parameter Reference Length Optional Text
BILL_HEADER_DATA BAPI1307HEADER 209 X IS-H: BAPI Billing Document: Header Data
BILL_ITEM_DATA BAPI1307ITEM 448 X IS-H: Billing Document Item Data
BPART_SRV_LINK_DATA BAPI1309SERVICELINK 53 X IS-H: Business Partner <-> Service Assignment (NNLZ)
CASE_DIAGNOSIS_DATA BAPI2098DATA 884 X IS-H BAPI Case Diagnosis Data
CASE_PROCEDURE_DATA BAPI1303DATA 382 X IS-H: BAPI Case-Procedure Data
CASE_SERVICE_DATA BAPI2099DATA 831 X IS-H BAPI Case-Based Service Data
INSURANCE_REL_DATA BAPI2097INSURREL 201 X IS-H: BAPI for Case-Related Insurance Relationship
PAT_ADDRESS_TABLE BAPINADDR 994 X IS-H: Addresses (Central Address Structure)
PAT_PHONE_TABLE BAPINADDR2 53 X IS-H BAPI Additional Telephone Numbers
PHYSICIAN_DATA BAPI1309PERSON 172 X IS-H BAPI Business Partner - Person Data
PHYS_SPECIAL_DATA BAPI1309PERSPEC 18 X IS-H BAPI Person-to-Specialty Assignment
RETURN BAPIRET2 548 X Return Messages

Functionality
This BAPI returns the case-specific invoice data (claim) for aninsurance provider.

Insurance Provider Specification
The data should to determined for an invoice addressed to a singleinsurance provider. The insurance provider can be specified eitherusing its identification key (import parameter INSURANCE_PROVIDER) orits internal insurance provider category (import parameterINS_PROVIDER_TYPE).
If the insurance provider ID and an insurance provider category arepassed to the method, the insurance provider ID is used for subsequentprocessing and the insurance provider category is ignored.
If only an insurance category is passed to the method, a check is runto ascertain whether there is only one insurance provider of thiscategory for the specified case. If several insurance providers exist,processing is discontinued.

Invoice
A number of invoices can exist for a case and an insurance provider.All invoices are returned as header and item data.

Example
Several insurance relationships with the same insurance provider canexist for a case. For example, there might be an insurance relationshipwith OHIP (Ontario Health Insurance Plan) from 05/01/2001 thru07/31/2001 with the contract scheme RMB (Reciprocal Medical Billing)and as of 08/01/2001 an insurance relationship with the contract schemeHCP (Health Claim Payment).
If services exist in both periods, two invoices are created for thesame insurance provider, and can be transmitted as an electronicinvoice.


INCLUDE NBAPI_WORST_RETURNED_MSGTY OBJECT DOKU ID TX
INCLUDE NBAPI_INSTITUTION OBJECT DOKU ID TX
INCLUDE NBAPI_PATCASEID OBJECT DOKU ID TX

Description
Errors that occurred are returned in this table.

Value range
INCLUDE NBAPI_RETS_ADMISSION_GET OBJECT DOKU ID TX