To check claim reply files have been loaded:
From the main menu of Toniq Dispensary, go to 4. Electronic claiming, then 1. Edit claim, to see the list of recent claims:
The claims as in order of creation, with the most recent claim at the top of the list.
Status
- New: Claim(s) that have not been sent to Te Whatu Ora for payment.
- There may be more than one New claim if pharmacy process requires daily claims.
- There should not be any New claims before Sent or Accepted claims. If there are, the pharmacy may have missed out on payments, contact Toniq for assistance.
- Sent: The claim file has been sent to Te Whatu Ora Sector Services. The reply file loaded has not been loaded. It may not have been processed by TWO and some or all items may not have been paid.
- Accepted: The claim file has been sent to Te Whatu Ora Sector Services and the reply file received, loaded and saved.
- Note: All historical claims should have replies loaded, i.e. have the status of Accepted.
To load a claim reply file:
- Select the Sent claim.
- Press F3 Load Reply.
- Press F12 Save Claim to save the claim with its reply.
- Note: do not press Esc (escape) as this will not save the reply.
Process
- Claim reply files should be loaded before the next batch is sent.
- Ideally, it should be loaded soon after it was sent to fix the errors (if any) immediately before the next claim file is created.
- The reply file is usually available by the next day and often within a few hours.
An automatic reminder to load the reply file is generally set to 3 days but can be changed in claim options if required.
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