A Benefit Set is the heart of the Core Flex policy workflow. A Benefit Set is a set of Line Items. The purpose of those Line Items is to first capture desired benefit amounts, chosen by the Authorization user, then calculate the estimated cost of those desired amounts and compare that cost to the Line Item’s budgeting constraints. If the user desires a value that is outside of the Line Item’s budgeting constraints, an exception is raised.
The general setup of a Benefit Set Line Item is as follows:
Create a new Benefit Set, including its name and description
Create the User Table Field that will store the user’s desired benefit amount
Create the Benefit Set Line Item, including the Line Item’s available benefit choices, minimum, maximum, and recommended choices, cost calculation, and the potential service to authorize
Benefit Sets are defined per Company. Create a Benefit Set by selecting the “Benefit Sets” menu item under the “Templates” menu group. Benefit Sets have the following fields:
Name – Required field. Must be unique among active Benefit Sets.
Description – For reference. Only seen on the Benefit Sets configuration page.
Inactive – Inactive Benefit Sets are no longer available when creating a new policy.
Data Entry Currency – The currency shown for all estimated costs when users enter their desired benefit amounts on the Services step of the Authorization. Can be overridden per line item.
Example of an empty Benefit Set:
Save the Benefit Set to enable the creation of Benefit Set Line Items.
Benefit Sets cannot be deleted if they are used either by a policy or have been used as part of an Authorization. Use the Inactive check box to deprecate previously-used Benefit Sets.