Overview

QFD performs general accounting operations required for claims processing. The system can be integrated with most real-time accounting service interfaces or support batch accounting file generation and delivery. When no services are available, these operations are performed manually. This section provides an overview of the core accounting components.

• Accounting Execution
• Accounting Rules
• Accounting Collections
• Accounting Tool
• Optional Accounting Configurations

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Accounting assignments are generated when the rules described in Accounting Rules are executed. The type of assignment that is generated depends on the integrations that are configured. The assignments are displayed in the Accounting step of the Case Rollup. There are three common configurations.

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Accounting Services

When a real-time accounting service integration is available the system will perform the accounting adjustments by calling the integration and passing the necessary information to perform the adjustment in the system of record.  This assignment does not require any user interaction and will be executed in accordance with the predefined SLA.

Batch File Accounting

If a real-time accounting service is not available, the system can be configured to perform batch accounting.  When this is enabled, a file is generated at configurable intervals and includes all the information that is necessary for the downstream system or user to complete the required adjustments.  Batch accounting is typically configured to execute once per day but can happen more frequently.  This assignment does not require any user interaction and will be executed in accordance with the predefined agent SLA which is visible on the assignment.

Manual Accounting

When no real-time or batch accounting service is configured, accounting becomes a manual assignment to be completed by a user.  The assignment will include the necessary details to complete the accounting operation in an external system.

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