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Benefit Domain

Domain Summary​

The Benefit domain manages healthcare benefit positions and services that can be provided to clients. It handles the creation, validation, and management of various types of benefits, including nursing care benefits, preventive care benefits, day care benefits, and private benefits.

This domain enables healthcare providers to define and maintain a catalog of available healthcare services, track benefit positions with their associated costs and requirements, and integrate these benefits into client contracts and prescriptions. It serves as a critical component for service definition and pricing within the healthcare platform.

Architectural Overview​

The Benefit domain follows the standard domain architecture pattern.

Entities​

  1. BenefitEntity - The aggregate root entity representing a healthcare benefit with:

    • Benefit identification
    • Benefit description (short and detailed)
    • Benefit class and number
    • Pricing information
    • Qualification requirements
    • Service area classification
    • Billing type information

  2. BenefitPosition - Entity representing a specific benefit position with:

    • Position identification
    • Service area information
    • Pricing details
    • Time requirements
    • Qualification requirements

  3. Specialized Benefit Entities:

    • BenefitComplexParagraph36Entity - Entity for complex nursing care benefits
    • CareAndDischargeBenefitParagraph45bEntity - Entity for care and discharge benefits
    • CompensationSurchargeBenefitParagraph43BEntity - Entity for compensation surcharge benefits
    • CounsellingSessionsBenefitParagraph37Abs3Entity - Entity for counselling session benefits
    • DayCareBenefitParagraph41Entity - Entity for day care benefits
    • PreventiveCareBenefitParagraph39Entity - Entity for preventive care benefits
    • PrivateBenefitEntity - Entity for private benefits
    • HomeNursingBenefitEntity - Entity for home nursing benefits
    • IndividualFlatRateHomeNursingBenefitEntity - Entity for individual flat-rate home nursing benefits

Key Operations​

Benefit Management​

  • Create and update benefit definitions
  • Validate benefit information against business rules
  • Categorize benefits by service area and type
  • Manage benefit pricing and requirements

Benefit Retrieval​

  • Get benefits by ID or position
  • Search benefits by criteria (service area, qualification, etc.)
  • Retrieve benefit details for client contracts
  • Find benefits for specific care needs

Validation Operations​

  • Validate benefit billing types
  • Ensure benefits meet qualification requirements
  • Verify benefit pricing and time requirements
  • Validate benefit combinations

Integration Operations​

  • Provide benefit information for contract creation
  • Support benefit selection for prescriptions
  • Enable benefit scheduling in calendars
  • Supply benefit details for invoicing

Integration with Other Domains​

The Benefit domain integrates with several other domains:

  1. Interview Order Contract Domain - Benefits are included in client contracts
  2. Prescription Domain - Benefits are prescribed as treatments
  3. Calendar Domain - Benefits are scheduled in benefit calendars
  4. Tour Planning Domain - Benefits influence work items in tours
  5. Billing Domain - Benefits determine pricing for invoices
  6. Budget Plan Domain - Benefits are used in budget planning