Module 5 · Payment & Settlement · 5.1
Payment Computation View
Payment is always computed at individual patient level and aggregated upward, never the reverse. Every node below is the same figure shown in Stage B, rendered as a connected chain. Scoped to Full portfolio.
Contract-level computation chain
1
Enrollment Trigger Verification
Trigger PASS
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2
Eligibility & Exclusion Reconciliation
Exclusions certified: 118
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3
Engagement Determination
PEMPM total SAR 3,049,800 · true-up SAR 0
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4
Denominator Lock
Denominator: 861
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5
Baseline & Final Measure Validation
Measured: 792 of 861
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6
Numerator Determination
Numerator: 517
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7
Gate Checks & Two-Stream Computation
Performance payment SAR 1,405,100
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8
Settlement Statement & Dispute Window
Net new payment: SAR 1,405,100