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					Submit A Consultation To Medical Aid




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Contents
Introduction ............................................................................................................................................ 3
2.     Bill a patient. ................................................................................................................................... 4
     2.1       Submit a consultation to medical aid. .................................................................................... 4
       2.1.1          Choose patient to bill. ..................................................................................................... 4
       2.1.2          Bill details. ....................................................................................................................... 5
       2.1.3          Claim response details. ................................................................................................... 8




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Introduction
      The MedEDI Training Manual will provide a comprehensive learning corner stone into the
MedEDI software program and an informative reference to be used there forth.

        The manual has a concreate structure making reference easier. The structure is as follows;

1. Category

        The category arranged tasks into groups of what they achieve.

1.1 Task

        The task is an overall function available via MedEDI.

1.1.1 Step

        A step or numerous steps make up each task and need to be completed to achieve the task.

1.1.1.1 Entity within a step

        Within steps there are sections which involve the user. These entity’s make up each step.
This guide describes how to use and understand these entity’s to complete each step.

         Following the structure of the manual will ensure the user is able to complete each task
listed in this document and understand the overall process.




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2.      Bill a patient.




2.1     Submit a consultation to medical aid.
To begin click, ‘Bill / Debit Patient(s)’ from the main menu.



2.1.1   Choose patient to bill.




        2.1.1.1 – Bill patient as private.
        The user has the option to bill a patient with a private bill. all private bills with be submitted
within MedEDI. All amounts billed privately instantly become patient liable debts on the system.

         2.1.1.2 – Select patient.
         The user can select the patient by, entering the surname, account number, filing ref number
or hitting F3 for the advanced search on their keyboard. The selected patients current information
will appear and the user can continue with their work.

        2.1.1.3 – Register new patient.
        When trying to bill a new patient that is not on the system, the user can use this function
and register the patient faster. Upon creation the users will return here.

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         2.1.1.4 – Change patient details.
         When the user is billing a patient but need to change or alter any of the current patient
details, this function will take them to the various patient details that can be amended. Once
finished the user will be returned here.

       2.1.1.5 – Reminders.
       The user is able to send custom reminders on specific set dates by different methods. The
reminders will be sent to the selected patient.



Click, ‘Bill Patient’ to continue.




2.1.2   Bill details.




        2.1.2.1 – Patient information.
        This information is the patient’s details for the selected patient of the bill.

        2.1.2.2 – Doctor.
        When billing a patient, the user needs to ensure the doctor that attended to the patient
during consultations details are here and correct.




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        2.1.2.3 – Ref. Dr.
        This is the name of the doctor that referred the patient. The referring doctor’s details are
usually entered during registration of selected patient. However the user can simply enter the
referring doctors details here to save onto the system.

        2.1.2.4 – Diagnoses.

        The user need to enter the patient’s diagnosis, by using an ICD-10 code, or start typing the
diagnosis or use the F3 to search for the correct diagnosis. There are 4 diagnoses fields available to
the user.

        2.1.2.5 – Consultation.

        The user should ensure that the code here is the correct consultation code. Default custom
consultation codes can be set in the in the patient’s account settings or for medical aid in the
MedEDI Administrator.

       2.1.2.6 – Administration fee.
       The Admin fee is an amount the practice can charge to the patient for administrative
purposes. This amount will not be sent to the medical aid but will become patient liable.

       2.1.2.7 – Op.
       This function was designed for Radiographers, who would do the actual consultation. This
information would be used for statistical and month end reports.

        2.1.2.8 – P.O.S.
        Place of Service is where the consultation was either performed, in the rooms or in hospital.

         2.1.2.9 – Venue.
         This will be the name of the facility where the consultation was done. This is an optional
field to enter.

       2.1.2.10 – Auth.
       When a bill needs special authorisation from the Medical aid, the user can enter this number
here and it will be send with the bill to the medical aid.

        2.1.2.11 – Comments.
        The user can enter comments regarding this specific consultation in to this box. Comments
entered and saved here will be printed on the Bill Invoice document relating to this bill. Comments
are only accessible via pushing the comments button located at various points throughout the
program. Comments made at various points of the program will be printed to the relating document
to what task the user is currently partaking in.

         2.1.2.12 – Bill date.
         The user must ensure that they select the correct date when billing. This date will be the day
of service or consultation date.




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        2.1.2.13 – Record macro.
        If the user has added bill items here, they can save all of the information as a macro. This
macro will then be available to play in the future. Macros remove the stress of repeatedly having to
enter large list of billed items.

       2.1.2.14 – Play macro.
       Once a Macro has been set up the user can select this option, find their macro using a
unique name they saved it under then select to play it. When its played, the bill details section will
be populated with all of the items saved in the macro.

         2.1.2.15 – View patient history.
         Selection of this button will navigate the user to a new screen. On this screen the user will
be presented with a formally laid out Patient Bill History Report document. This document contains
all of the patients bill history and details regarding each bill. The financial amounts of each billed
item are clear. The user is able to print this document, or save a copy to their computer.

        2.1.2.16 – View / Add patient notes.
        Selection of this button will navigate the user to a new screen. On this screen the user will
be presented with a formally laid out Patient Notes document. Here the user can view all previously
created notes made on the patient. These visible notes are created through this particular notes
function. The user can add to the document from the current screen. These notes will not be printed
onto any documentation and should be kept internally to MedEDI.

         2.1.2.17 – Chg. Rate.
         The charged amount to a patient for a consultation, procedure or medication is directly
affected by the rate chosen here. These rates are set up, by MedEDI for the different Medical aid
Schemes according to their individual billing rates and rules. However the user can personalize these
rates in the MedEDI administrator.



Click, ‘Submit Bill’ to continue.




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2.1.3   Claim response details.




       2.1.3.1 – Result.
       Once the claim has been send to the medical aid, the switch between the user and the
scheme will give a status. Eg. Sent to switch, Claim rejected, Claim approved etc.

        2.1.3.2 – Patient.
        This is the patient’s information that was send to the medical aid with the bill information.

        2.1.3.3 – Claim information.
        This information will reflect reference numbers, date of service and the total that will be
settled by the medical aid for the claim sent.

        2.1.3.4 – Message.
        This information describes the reason behind the claim responses from the scheme
themselves. This information will assist the user if there are any claim problems or for future
references regarding the claims.

        2.1.3.5 – Print details.
        The details document is the full immediate claim response details received back from the
medical from this claim. The document itself will be presented in a formal report style layout and
printed upon selection of a printer by the user.

        2.1.3.6 – Print invoice.
        The Invoice document is the full tax invoice, created by the user during the billing process.
The invoice is the bill details laid out in a formal report. Upon selection of a printer to use by the
user, the document will be printed.


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       2.1.3.7 – Print statement.
       The account statement shows the full bill history for every patient who is listed in the
account. This provides a full financial statement of all transactions and the final amounts
outstanding, both medical aid due and patient due. Upon selection of a printer to use by the user,
the document will be printed.

        2.1.3.8 – E-Mail response.
        Upon selection of this button a new window will appear. On the new window the user is
able to enter the address subject and message of the E-mail. There are various text editing options
available to the user to customise the appearance of the text. The user is also able to insert variables
into the message. This will retrieve information from the users database for an easier method of
inserting information. The E-mail will automatically attach the Response document and send it along
with any message the user enters.


Click, ‘Ok’ to continue.




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