Find Member – the new name for Membership Enquiry

If you access our services through the Veda hub and also have a subscription to one of our Financial Management Solutions this is a quick and easy way to check the membership details of your patients.

This feature has recently had a facelift and, in line with our modern brand, it’s one of the first services to use our API first development promised by our Transformation Programme. You can now also navigate using your keyboard.

Getting started

Click the Records & Reporting tab, then Find Member. This section can also be accessed from the Quick Links menu on the Status page or by clicking the blue square Menq button at the bottom of the menu bar on the right-hand side of the page.

This’ll open Healthcode Authorisation in a new tab which you can leave open in the background. The first time you access the feature you’ll get a welcome message explaining what this feature offers (the ability to view any existing and request new pre-authorisations is coming soon) which you can choose not to see again.

Find your patient’s insurer membership details

• Click on Find a Member or press A on your keyboard
• Select the insurer by clicking the tile or pressing the corresponding letter on your keyboard
• Using your mouse to click into each field or pressing the tab key on your keyboard, complete the insurer’s mandatory fields as a minimum – these will be marked with an asterisk
  • First Initial
  • Last Name
  • Sex
  • Date of Birth – you can either type this in or use the date picker
  • Postcode
  • Membership Number
  • Group ID
  • Policy Active On – by choosing the date of treatment you can make sure the policy will be valid
• Click Search or press Enter on your keyboard
• You’ll get an instant response

We’ve found a match

This is split into two sections – patient information and policy information. The info shown is what the insurer has made available and we have no control over this.

Patient information

• Name
• Other Initials
• Sex
• Gender Identity
• Date of Birth
• Address

Policy information

• Indication of whether the policy is active or not
• Cover valid from and to dates
• Membership number*
• Insurance scheme/plan*
• Indication of whether the policy has expired
• Expiry date
• Group ID*
• Benefit limit
• Benefit used
• Member excess
• Excess used
• Member co-payment
• Insurer email address*
• Insurer phone number*

^{*There’s an easy to use copy function next to these fields – simply click the icon and paste the info wherever you need it.}

When you’ve reviewed and copied any relevant info click the Home icon at the top left of the screen. Any searches that you’ve done today will be shown on the right-hand side. You can click these at any point throughout the day to view the results again.

No match and multiple matches

If we can’t find a match we’ll let you know and give you further guidance.

The post VEDA | Authorisation – Find Member appeared first on Healthcode.

View invoices sent to patientzone

This is the third tab on the dashboard after clicking the Billing tab, Insurer Feedback and then Collection Service.

This section lists the invoices that have been sent to patientzone with the following columns:

• Date Created
• Family Name
• Payor Name
• Insurer
• Date Of Birth (of patient)
• Invoice No.
• Amount Due
• Reminder Status
• Actions
• Collection Status

You can filter the list in many ways.

• Collection Status
  • Any
  • Generated
  • Sent to collection service
  • Received
  • Submission Failure
  • Submission Error
  • Paid
  • Paid (Offline)
  • Closed
  • The invoice has been cancelled
• Date Of Birth
• Date Created – with an additional choice of a “to” date
• Reminder Status
  • All reminder bands
  • None
  • Band 1 Sent
  • Band 2 Sent
  • Band 3 Sent
  • Expired
• Source
  • All
  • Shortfall Invoice (see Shortfall Collection Service overview)
  • Self-Pay Invoice
• Insurer – not applicable
• Search Text – use this option to search for a specific name or invoice number; this will only search for things that appear on the screen and not for text within the invoice itself

Understanding the Reminder Status column

You can visually see the reminder status by the colour-coded boxes. Reminders are sent using aged debt bands (1-3) – you determine the timing of these bands.

• Three empty boxes = no reminders have been sent
• One green box = the first reminder (Band 1) has been sent
• Two green boxes = the first and second reminders (Bands 1 and 2) have been sent
• Three green boxes = all reminders (Band 1-3) have been sent
• Single yellow box outlined in red = the reminder period has expired – there are no more reminders available to send

Understanding the Collection Status column

This shows the status of the invoice within the process.

• Generated = the invoice has been uploaded and is awaiting further processing
• Sent to collection service = the invoice has been sent to patientzone along with the collection letter
• Received = patientzone has received the invoice and collection letter and has forwarded these to the payor
• Submission Failure = the invoice has failed the submission process – you can edit it by clicking the Edit Invoice icon in the Actions column
• Submission Error = an error has occurred while submitting the invoice but the system will retry
• Paid = the invoice has been paid on the patientzone portal
• Paid (Offline) = you have received payment by another method and have informed patientzone to remove this invoice from their outstanding items
• Closed = you have informed patientzone to remove this invoice from their outstanding items

Understanding the Actions column

You can click the icons in the column to perform additional tasks on individual invoices. From left to right these icons show you the following tooltips when you hover the mouse cursor over it: Download Invoice, Pay or Close Invoice, Edit Invoice, Stop Reminders / Start Reminders.

View and/or download an invoice and corresponding collection letter

• Click the first icon next to the required invoice to open a PDF file in your preferred application
• Close this after viewing or download the file to a location of your choice, renaming it if you want

Pay or Close Invoice

You can alert patientzone that they no longer need to keep the invoice outstanding on their system by marking an invoice paid or closed. Use this option when it’s been paid to you directly or you want to write it off or remove it for any other reason. At patientzone the invoice balance will be reduced to zero and will no longer be available to pay online. This action is final and can’t be reversed.

• Click the second icon next to the invoice you want to mark as paid or closed
• The Updating Invoice pop-up will open showing the invoice number at the top of the pane
• Click the required option and click Confirm
• The Collection Status will change to reflect your choice and the icon will be greyed out

Edit Invoice

If the invoice shows a Collection Status of Submission Failure this could be because there’s an issue with the mobile number or email address. You can make the necessary changes directly in the system. You can also make changes to these fields even if the invoice has previously been submitted – perhaps you’ve realised that you were using an incorrect, but perfectly formatted, email address or an old mobile phone number.

• Click the third icon next to the required invoice
• The Invoice Details pop-up will open giving you details of what the issue is and allow you to update the mobile phone number and email address
• Click Save
• The incorrect invoice will be cancelled and new invoice will be automatically generated and sent to patientzone – there’ll be no change to the invoice number
• If the update has been successful the Collection Status will change to Sent to collection service

Reminders

Reminders are sent automatically at intervals you’ve determined, but there may be instances where you would like to override the defaulted timescales. You can stop and start the reminder process as often as you like. When restarting the reminders will continue from where you previously stopped them.

Stop reminders

• Click the fourth icon next to the required invoice
• The Stop reminders pop-up will open showing the invoice number at the top of the pane
• Click Confirm
• The icon will change colour to red and the reminder process will be paused until you start it again

Start reminders

• Click the fourth icon (now coloured red) next to the required invoice
• The Start reminders pop-up will open showing the invoice number at the top of the pane
• Click Confirm
• The icon will change colour to blue and the reminder process will resume

The post Self-pay Collection Service | View Invoices appeared first on Healthcode.

Make it painless to send self-pay invoices and reminders through our secure portal

Using the Clearing Service our Self-pay Collection Service allows you to send electronic invoices to patients – just like you do to the insurers. You can also send reminders.

This service is accessed from the Billing tab. Click Insurer Feedback and then Collection Service to open the dashboard. You’ll see three tabs:

• Maintain Collection Messages
• Unmatched Remittances
• View Invoices

The Maintain Collection Messages and Unmatched Remittances tabs are only used if you’re a hospital, practice or clinic using our Shortfall Collection Service. This isn’t available to single practitioners at the moment.

View Invoices

This is the section that shows you the status of the invoices that have been sent to patientzone. You can also perform additional tasks from this section, such as pausing and restarting reminders. See what you can do here.

The post Self-pay Collection Service | Overview appeared first on Healthcode.

Membership number formats

We’ve got access to the membership databases for Aviva, AXA Health, Bupa and Vitality and invoices are validated against these. The other insurers validate against membership number formatting rules.

The validation format criteria are set out for each insurer and use the following key:

• A = Letter
• N = Number
• X = Letter or Number

A couple of examples:

• AANNNN = 2 letters followed by 4 numbers
• NNNNNNXXA = 6 numbers, followed by 2 characters than can either be a number or a letter, followed by a letter

Where other letters and specific letters or symbols are used, this is clearly shown.

Alliance Health

There are three formats that are recognised.

• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNN = 8 numbers

Allianz Partners

The letter P followed by between 4 to 9 numbers.

As Allianz are now processing invoices on behalf of Aetna for their Americas policy holders, the following formats are also recognised. More information on what that means can be found here.

• WNNNNNNNNN = the letter W, followed by 9 numbers
• WNNNNNNNNN-NN = the letter W, followed by 9 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNNNNNNNN = the letter W, followed by 10 numbers
• WNNNNNNNNNN-NN = the letter W, followed by 10 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNN⎵NNNNN = the letter W, followed by 4 numbers, followed by a space, followed by 5 numbers
• WNNNN⎵NNNNN-NN = the letter W, followed by 4 numbers, followed by a space, followed by 5 numbers, followed by a hyphen (-), followed by 2 numbers
• WNNNN⎵NNNNNN = the letter W, followed by 4 numbers, followed by a space, followed by 6 numbers
• WNNNN⎵NNNNNN-NN = the letter W, followed by 4 numbers, followed by a space, followed by 6 numbers, followed by a hyphen (-), followed by 2 numbers

Bupa Global

Must be 17 characters long.

• XX-NNNN-NNNN-NNNN = 2 characters (often the letters BI), followed by a hyphen (-), followed by 4 numbers, followed by a hyphen (-), followed by 4 numbers, followed by a hyphen (-), followed by 4 numbers

Exeter Friendly

There are seven formats that are recognised.

• NNNNN = 5 numbers
• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNNNN = 10 numbers
• NNNNNNNNPPNN = 8 numbers, followed by the letter P, followed by the letter P, followed by 2 numbers
• WINNNNNNNN = the letter W, followed by the letter I, followed by 8 numbers
• WDNNNNNNNN = the letter W, followed by the letter D, followed by 8 numbers

WPA

There are five formats that are recognised.

• NNNNN = 5 numbers
• NNNNNN = 6 numbers
• NNNNNNN = 7 numbers
• NNNNNNNN = 8 numbers
• NNNNNNNNN = 9 numbers

The post Validation Rules | Membership numbers appeared first on Healthcode.

Authorisation number formats

Getting your patient pre-authorised gives you peace of mind that their policy allows them to have the requested treatment. But remember, it’s not a guarantee of payment. Adding the pre-authorisation number (sometimes also known as claim number or patient assessment number) onto your invoice shows the insurer that someone has been in touch prior to treatment to let them know what’s going on. If you’re going to add it you need to make sure the format is correct to stop your invoices failing validation.

The pre-authorisation number is optional for the insurers, unless otherwise stated. The only insurer that doesn’t validate these is AXA Health, so we haven’t included the format requirements in this guide.

The validation format criteria are set out for each insurer and use the following key:

• A = Letter
• N = Number
• X = Letter or Number

A couple of examples:

• AANNNN = 2 letters followed by 4 numbers
• NNNNNNXXA = 6 numbers, followed by 2 characters than can either be a number or a letter, followed by a letter

Where other letters and specific letters or symbols are used, this is clearly shown.

Alliance Health

There are two formats that’ll pass validation.

• AAANNNNN = 3 letters, followed by 5 numbers
• A-ANNNNN = a letter, followed by a hyphen (-), followed by a letter, followed by 5 numbers

Allianz Partners

There’s no set length – it can be a combination of letters, numbers and can also include a hyphen.

Aviva

There are four formats that’ll pass validation.

• NNNNNN/NN/NNNN/NNN = 6 numbers, followed by a forward slash (/), followed by 2 numbers, followed by a forward slash, followed by 4 numbers, followed by a forward slash, followed by 3 numbers
• NNNNNN\NN\NNNN\NNN = 6 numbers, followed by a backslash (\), followed by 2 numbers, followed by a backslash, followed by 4 numbers, followed by a backslash, followed by 3 numbers
• NNNNNN/NN = 6 numbers, followed by a forward slash (/), followed by 2 numbers
• NNNNNN\NN = 6 numbers, followed by a backslash (\), followed by 2 numbers

Bupa

There’s no set length – it must be all numbers.

Bupa Global

There are two formats that will pass validation, both must start with the letter A:

• ANNNNNNN = the letter A, followed by 7 numbers
• ANNNNNNNN = the letter A, followed by 8 numbers

Healix

There’s no set length – it can be a combination of letters and numbers.

Trust in Health

You must include a pre-authorisation number on any invoice. It must start with THP, followed by a letter and 6 numbers.

VitalityHealth

There are three formats that’ll pass validation and all must start with the number 1, 5 or 9.

• NNNNNN = 6 numbers but the first must be a 1, 5 or 9
• NNNNNNN = 7 numbers but the first must be a 1, 5 or 9
• NNNNNNNN = 8 numbers but the first must be a 1, 5 or 9

WPA

There are two formats that’ll pass validation.

• NNNNNNNNN = 9 numbers
• XXXXXX = 6 characters – can be any combination of letters and numbers

The post Validation Rules | Authorisation numbers appeared first on Healthcode.

View invoices sent to patientzone

This is the first tab on the dashboard after clicking the Billing tab, Insurer Feedback and then Collection Service.

This section lists the invoices that have been sent to patientzone for collection with the following columns:

• Date Created
• Family Name
• Payor Name
• Insurer
• Date Of Birth (of patient)
• Invoice No.
• Amount Due
• Reminder Status
• Actions
• Collection Status

You can filter the list in many ways.

• Collection Status
  • Any
  • Generated
  • Sent to collection service
  • Received
  • Submission Failure
  • Submission Error
  • Paid
  • Paid (Offline)
  • Closed
  • The invoice has been cancelled
• Date Of Birth
• Date Created – with an additional choice of a “to” date
• Reminder Status
  • All reminder bands
  • None
  • Band 1 Sent
  • Band 2 Sent
  • Band 3 Sent
  • Expired
• Source
  • All
  • Shortfall Invoice
  • Self-Pay Invoice (see Self-pay Collection Service overview)
• Insurer
• Search Text – use this option to search for a specific name or invoice number; this will only search for things that appear on the screen and not for text within the invoice itself

Understanding the Reminder Status column

You can visually see the reminder status by the colour-coded boxes. Reminders are sent using aged debt bands (1-3) – you determine the timing of these bands.

• Three empty boxes = no reminders have been sent
• One green box = the first reminder (Band 1) has been sent
• Two green boxes = the first and second reminders (Bands 1 and 2) have been sent
• Three green boxes = all reminders (Band 1-3) have been sent
• Single yellow box outlined in red = the reminder period has expired – there are no more reminders available to send

Understanding the Collection Status column

This shows the status of the invoice within the process.

• Generated = the invoice has been intercepted on a remittance advice and is awaiting further processing
• Sent to collection service = the invoice has been sent to patientzone along with the collection letter
• Received = patientzone has received the invoice and collection letter and has forwarded these to the payor
• Submission Failure = the invoice has failed the submission process and can’t be resubmitted without manual intervention
• Submission Error = an error has occurred while submitting the invoice but the system will retry
• Paid = the invoice has been paid on the patientzone portal
• Paid (Offline) = you have received payment by another method and have informed patientzone to remove this invoice from their outstanding items
• Closed = you have informed patientzone to remove this invoice from their outstanding items

Understanding the Actions column

You can click the icons in the column to perform additional tasks on individual invoices. From left to right these icons show you the following tooltips when you hover the mouse cursor over it: Download Invoice, Pay or Close Invoice, Edit Invoice, Stop Reminders / Start Reminders.

View and/or download an invoice and corresponding collection letter

• Click the first icon next to the required invoice to open a PDF file in your preferred application
• Close this after viewing or download the file to a location of your choice, renaming it if you want

Pay or Close Invoice

You can alert patientzone that they no longer need to keep the invoice outstanding on their system by marking an invoice paid or closed. Use this option when it’s been paid to you directly or you want to write it off or remove it for any other reason. At patientzone the invoice balance will be reduced to zero and will no longer be available to pay online. This action is final and can’t be reversed.

• Click the second icon next to the invoice you want to mark as paid or closed
• The Updating Invoice pop-up will open showing the invoice number at the top of the pane
• Click the required option and click Confirm
• The Collection Status will change to reflect your choice and the icon will be greyed out

Edit Invoice

If the invoice shows a Collection Status of Submission Failure this could be because there’s an issue with the patient’s address, mobile number or email address. You can make the necessary changes directly in the system. You can also make changes to these fields even if the invoice has previously been submitted – perhaps you’ve realised that you were using an incorrect, but perfectly formatted, email address or an old mobile phone number.

• Click the third icon next to the required invoice
• The Invoice Details pop-up will open giving you details of what the issue is so you can amend it -you can also update the mobile phone number and email address, even if they didn’t cause the failure
• Click Save
• The incorrect invoice will be cancelled and new invoice will be automatically generated and sent to patientzone – there’ll be no change to the invoice number, even if they didn’t cause the failure
• If the update has been successful the Collection Status will change to Sent to collection service

Reminders

Reminders are sent automatically at intervals you’ve determined, but there may be instances where you would like to override the defaulted timescales. You can stop and start the reminder process as often as you like. When restarting the reminders will continue from where you previously stopped them.

Stop reminders

• Click the fourth icon next to the required invoice
• The Stop reminders pop-up will open showing the invoice number at the top of the pane
• Click Confirm
• The icon will change colour to red and the reminder process will be paused until you start it again.

Start reminders

• Click the fourth icon (now coloured red) next to the required invoice
• The Start reminders pop-up will open showing the invoice number at the top of the pane
• Click Confirm
• The icon will change colour to blue and the reminder process will resume

The post Shortfall Collection Service | View Invoices appeared first on Healthcode.

Unmatched remittances

This is the third tab on the dashboard after clicking the Billing tab, Insurer Feedback and then Collection Service.

The automated Shortfall Collection Service matches confirmed patient liability ISSCs on the remittance advice to mapped provider collection messages. When a mapping doesn’t exist the remittance is suspended to allow you time to resolve the issue and any invoices affected are listed under this tab. You should check this section regularly.

For each insurer you’ll see the following:

• The ISSCs that are unmatched to a collection message
• The amount that has been identified as a patient liability
• The insurer description as it appears on the remittance advice

Simply follow these steps to map the appropriate collection message:

• Click the ICCS you want to match and then click Edit Code at the bottom right of the screen – the Edit Unmatched pop-up will appear, listing all the parameters
• Click in the Provider Shortfall Code box to display a drop-down menu of your collection messages
• Use the scroll bar if you need to choose the most appropriate one
• Click Save and a confirmation message will appear
• Click X to close

If there isn’t a suitable option available simply add a new message code. See Add a message code in our Maintain Collection Messages for further information on how to do this.

Any invoices featuring the same ISSC from the same insurer will disappear from the Unmatched Remittances list. These have now been sent to patientzone for collection and will appear in the View Invoices section.

The post Shortfall Collection Service | Unmatched Remittances appeared first on Healthcode.

Maintain collection messages used in the letters sent by patientzone

This is the second tab on the dashboard after clicking the Billing tab, Insurer Feedback and then Collection Service.

This contains the list of your collection messages used in the patient collection letters sent by patientzone. Each one consists of a message code and description that you’ve set. You need to map your messages to the available Industry Standard Shortfall Codes (ISSCs).

In this section you can:

• Add a message code
• Add mapping to a new or existing message code
• View linked ISSC mappings
• Delete mapping from an existing message code
• Edit a message description
• Delete a message code

Add a message code

Simply follow these steps:

• Click Add Code in the bottom left of the screen – the Add Message Code pop-up will appear
• Type in a Code – any combination of letters, numbers or symbols
• Add a Description of up to 2,000 characters – this is the message you want to use in the collection letters
• Click Save

Your new message will appear in the list. You now have to map it to an ISSC.

Map a message to an ISSC

• Click on the message then click Add Mapping on the bottom right of the screen – the Add Mapping pop-up will appear, listing the selected code at the top of the pane
• Choose the category from the drop-down options; the available ISSCs are shown in the box at the bottom of the pane
• Choose the one most relevant for you by highlighting it and then click Save
• A “+” symbol will appear next to the message in the list

View linked ISSC mappings

• Messages with mapped ISSCs are indicated by a “+” symbol
• Click on the “+” symbol to reveal the linked ISSCs – you can have as many mapped to a single collection message as you want

Delete an ISSC mapping

• Follow the instructions on how to view linked ISSC mappings
• Click the mapping you want to delete
• Click Delete Mapping on the bottom right of the screen
• Click OK on the confirmation message

Edit a message description

• Click on the message then click Edit Code on the bottom left of the screen – the Edit Code pop-up will appear, listing the selected code at the top of the pane
• The current message is displayed in the Description box
• Make the necessary change and click Save

You can’t edit the code, just the description. If you need to, just delete the old code and add a new one by following the instructions.

Delete a message code

• Click on the message then click Delete Code on the bottom left of the screen
• Click OK on the confirmation message

The post Shortfall Collection Service | Maintain Collection Messages appeared first on Healthcode.

Hospitals, take the headache out of dealing with patient liability shortfalls

The Shortfall Collection Service automatically identifies and notifies your patients of any outstanding amounts – so they know as soon as you do. We map multiple insurer shortfall messages from electronic remittances to a single set of Industry Standard Shortfall Codes (ISSCs) and we’ve teamed up with patientzone to offer your patients a secure and easy way to pay online. It couldn’t be simpler.

This service is accessed from the Billing tab. Click Insurer Feedback and then Collection Service to open the dashboard. You’ll see three tabs:

• View Invoices
• Maintain Collection Messages
• Unmatched Remittances

View Invoices

This is the section that shows you the status of the invoices that have been sent to patientzone. You can also perform additional tasks from this section, such as amending invoices that have failed submission and pausing and restarting reminders. See what you can do here.

Maintain Collection Messages

This section contains the list of your messages used in the patient collection letters sent by patientzone. Read more about this section here.

Unmatched Remittances

This section shows any remittances where there wasn’t a match between a patient liability ISSC and a mapped collection message. Find out more about this here.

The post Shortfall Collection Service | Overview appeared first on Healthcode.