eClaims Hybrid – Returned Files
To save time double reconciling payments, eClaims can produce a file with the exceptions and payment data, so that it can be imported back into your main system.
We can produce these files either in XML or Excel format.
Note – nothing is returned back for Patient Claims.
Exception Statement
XML
Each item is export in the exception file, not just items that were rejected or paid a different amount.
- Batch Number
- External Servicing Dr Id
- Claim Date
- Total Paid i.e. for the entire batch
- Voucher/Invoice Information
- Id
- VVSS, the first 2 digits (VV) represent the voucher position within a batch and the next 2 digits (SS) represent the service position within the voucher
- External Patient Id
- External Invoice Id
- Patient Surname
- Patient First name
- Patient Medicare Number
- Medicare Flag
- A – Patient identification has been amended
- I – Patient medicare issue number changed
- C – Patient medicare number changed
- W – Patient card used will expire shortly
- S – Patient card expired. Future services may be rejected
- X – Old Medicare issue number for patient. Future services may be rejected
- empty – no change
- Veterans Number
- Veterans Flag
- A – Patient identification has been amended
- C – Patient veterans number change
- empty – no change
- Item Number
- Date of Service
- Amount Paid
- Exception Code
- Explanation Text
- Medicare Benefit (only provided when an ECLIPSE claim)
- Health Fund Benefit (only provided when an ECLIPSE claim)
- Health Fund Exception Code (only provided when an ECLIPSE claim)
- Health Fund Explanation Text (only provided when an ECLIPSE claim)
- Id
Flat File
Unlike the XML version, we only export the items that had a rejection or were paid a different amount to what was claimed.
- External Patient Id
- External Invoice ID
- Item
- Date of Service
- Amount
- Exception Code
- Batch Number
Payment File
XML
- Batch Number
- External Servicing Dr Id
- Claim Date
- Total Claim Amount Paid
- Run Date
- Run Number
- Voucher Information
- Id
- VVSS, the first 2 digits (VV) represent the voucher position within a batch and the next 2 digits (SS) represent the service position within the voucher
- External Patient Id
- External Invoice Id
- Patient Surname
- Patient First Name
- item Number
- Date of Service
- Amount Paid
- Id
Flat File
- External Patient Id
- External Invoice Id
- External Servicing Dr Id
- Amount Paid
- Payment Date
- Run Number
Notes
External Doctor ID / External Patient ID / External Invoice ID – As long as this was provided when the data was imported, then we can include this when these export files are created.
Sample File
Last updated: September 5, 2018 at 12:07 pm