Care Plan Advanced Renewal Logic

Care Plan Advanced Renewal Logic

Estimated reading time: 4 min

In RxWorks when a patient care plan reaches the renewal date it is picked up by the renewals background task. For each plan that is due to renew RxWorks will firstly validate the patient care plan and if it passes validation it will attempt to identify the care plan to renew onto. The logic to do this will firstly identify all care plans that match the patient’s details, i.e. age, sex, D.O.B etc., it will then filter to only care plans that are in the same category as the originating plan and only plans that are available as of the start date of the new plan. With the remaining list a single plan needs to be found, this is done using the following business logic in this order until a single plan is left:

  1. If the same care plan as the originating plan is available use this
  2. If there are multiple plans with age restrictions that are all met, select the plan with the oldest age restriction
  3. If there are multiple plans with weight restriction that are all met, select the plan with the largest weight restriction
  4. Select the plan with the most amount of matched rules.

If a care plan cannot be found no renewal will be performed.

In RxWorks 5.3 we have introduced two new advanced rules that can be applied to care plan renewals in order to have more control over what plan will be selected at renewal. The two new rules are:

  1. Renewal By Specific Plan
  2. Renewal By Sub Category

The details for how these work and how they are configured can be found below. These rules are applied prior to the current business logic when resolving a single care plan from a list of care plans that match the current care plan category, the plan start date and the patient’s details. If these new rules do not resolve to a single plan the above business logic is still applied on top of these rules.

Renewal By Specific Plan Type

This logic allows you to specify a specific plan a care plan should renew on to. I.e. if you want to offer different treatments on the second instance of a care plan you could have two separate plans but you could configure plan A to always renew on to plan B. This could then also be used if you wanted to offer a different range of treatments on every second instance of a care you could configure plan A to renew on to plan B and plan B to renew onto plan A.

This is configured on the care plan configuration screen under the renewals section:

When a ‘Specific Plan’ is selected as a renewal option this will be the preferred plan to renew onto, if this specific plan is found in the list of plans the plan can renew onto it will be selected.

Renewal By Sub Category

This logic allows you to sub categorise your plans so you know within a care plan category what plans will renew to what. This is useful if you offer a monthly and an annual option, you may want to keep the plans in the same category as they are for the same treatment it is just the payment method that is different, however you don’t want annual payers to renew onto a monthly plan as they will not have direct debit details set up.

This is configured on the care plan configuration screen under the renewals section:

This is broken down into:

  • Sub Category – Applicable to this plan, i.e. what sub category this plan belongs to
  • Renewal Sub Category – The sub category this plan should renew onto
  • With these two fields, as above you could ensure Direct Debit plans always renew onto Direct Debit plans by setting both the Sub Category and the Renewal Sub Category to ‘Direct Debit’ or alternatively you could use this to ensure a certain plan always renews onto a plan in a different sub category. For example if you want to offer different treatments on the second instance of a care plan you could have two sub categories plans A’s and Plan B’s, that way plan A plans would always renew onto plan B plans.

    To set up sub categories you simply need to add a new care plan category:
    Options and Setup > Item – Care Plan Categories > Add

    On the add screen tick the ‘Renewal Sub Category’ box:

    This will mark this category as a renewal sub category only and will therefore only be visible within the sub category drop downs on the care plan configuration screen.

    Notes

    • Both rules can be used in conjunction
    • These new rules can be used in conjunction however the ‘Specific Care Plan’ rule will take precedence over the care plan sub category rule. As an example you could say Plan A always renews to Plan B (Specific Care Plan Rule), but also set Plan A to renew on to the Plan B’s sub category (Renewal Sub Category Rule), this way if Plan B is available it will be chosen for renewal, if for some reason it is not available the most relevant other plan from the same sub category will be chosen.

    • Renewal Sub Category
    • This is applied on manual renewals as well as automatic renewals. I.e. if Plan A is configured to renew onto sub category B plans, then when manually renewing only plans that are in sub category B will be shown

    • Renewal Date
    • By default this is 30 days before the plan is due to end, however this is configurable in Care Plan Global Settings.

    • Validate Patient Care Plans
    • When a patient care plan is due for renewal the following validations have to be passed in order for a renewal to be performed:
      Patient Is Active

      • Plan Is Configured to Auto Renew
      • Plan has not already been renewed
      • Plan has not been cancelled
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