Introduction

Late Payment Interest (LPI) is a feature in the Pega Smart Claims Engine for Healthcare that supports the calculation of interest for the claims which are approved to pay but delayed in payment from the payer. Each claim being adjudicated through Smart Claims Engine for Healthcare that has a status of Pending-approved or Pending-partialpaid is eligible for LPI calculation. Smart Claims Engine for Healthcare also provides an LPI report where the payer can see how much LPI incurred on the claims. The feature includes:

• LPI is calculated for the claim header approved amount if the claim is in Pending-approved status.
• LPI is calculated for the claim line approved amount if the claim line is in Approved status and the claim is in Pending-partialpaid status.
• The calculated LPI amount, the number of days for which LPI is calculated, and the rate of interest at which LPI is calculated are present on claim and shown in UI as well.