Entity MClaimCycle

Description of Entity MClaimCycle

This entity sets the medical claim policy limits.


List of all Dependencies of the Entity MClaimCycle

Name

Code

Class Name

Relation_244177

Relation_244177

Reference


List of Attributes of the Entity MClaimCycle

Name

Code

Medical Claim Policy ID

MedClaimPolicyId

MedClaimCycleSysId

MedClaimCycleSysId

From

MedClaimCycleStart

To

MedClaimCycleEnd

Limit No of Claims per Policy

LimitPerPolicy

NoPerPolicy

NoPerPolicy


Entity Attribute Medical Claim Policy ID of the Entity MClaimCycle

Card of Attribute Medical Claim Policy ID of the Entity MClaimCycle

Name

Medical Claim Policy ID

Code

MedClaimPolicyId

Data Type

char(20)

Mandatory

Yes


Description of Attribute Medical Claim Policy ID of the Entity MClaimCycle

Shows the identity of the medical claim policy. It also acts as a primary key for the MClaimPolicy table.
Example: Co. Medical Policy


Entity Attribute MedClaimCycleSysId of the Entity MClaimCycle

Card of Attribute MedClaimCycleSysId of the Entity MClaimCycle

Name

MedClaimCycleSysId

Code

MedClaimCycleSysId

Data Type

integer

Mandatory

Yes


Description of Attribute MedClaimCycleSysId of the Entity MClaimCycle

A system generated identity. It is blind to the user. It holds the primary key for the MClaimCycle table.


Entity Attribute From of the Entity MClaimCycle

Card of Attribute From of the Entity MClaimCycle

Name

From

Code

MedClaimCycleStart

Data Type

date

Mandatory

No


Description of Attribute From of the Entity MClaimCycle

Shows the starting date for the medical claim cycle.
It is in the format: DD-MM-YYYY.


Entity Attribute To of the Entity MClaimCycle

Card of Attribute To of the Entity MClaimCycle

Name

To

Code

MedClaimCycleEnd

Data Type

date

Mandatory

No


Description of Attribute To of the Entity MClaimCycle

Shows the end date of the medical claim cycle.
It is in the format: DD-MM-YYYY.


Entity Attribute Limit No of Claims per Policy of the Entity MClaimCycle

Card of Attribute Limit No of Claims per Policy of the Entity MClaimCycle

Name

Limit No of Claims per Policy

Code

LimitPerPolicy

Data Type

double

Mandatory

No


Description of Attribute Limit No of Claims per Policy of the Entity MClaimCycle

Shows the limited number of claims per policy, in a form of a checkbox. Each approved claim amount is deducted from this.
Example: An amount of '1000' is set here and an employee submits 3 medical claims, each 35.71, the balance would be 892.87, i.e. 1000-(35.71x3).

When the limit is reached, no more claim submissions can be submitted for this employee, regardless of the number of submissions remaining. If you have the ePortal application, each time a claim is submitted, the policy limits are checked and if exceeded, an error message is displayed. The employee would then be prevented from submitting a claim.


Entity Attribute NoPerPolicy of the Entity MClaimCycle

Card of Attribute NoPerPolicy of the Entity MClaimCycle

Name

NoPerPolicy

Code

NoPerPolicy

Data Type

integer

Mandatory

No


Description of Attribute NoPerPolicy of the Entity MClaimCycle

Shows the number of medical claim submissions per employee. Similar to the LimitPerPolicy attribute, when the limit is reached, the employee cannot submit his/her claims, regardless of the amount of limit remaining. If you have the ePortal application, each time a claim is submitted, the policy limits are checked and if exceeded, an error message is displayed. The employee would then be prevented from submitting a claim.