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» Medical Scheme Interim Advice (Medres)
The Medres is returned via MediSwitch by participating medical schemes / administrators to provide the practice with prompt notification of rejected claims during the initial adjudication process as well as claims that are accepted for further processing (interim report).
The Medres report is automatically returned to the practice by MediSwitch and can be printed together with the feedback reports. Practices can also access their Medres reports via WEBDesk. The detail contained in the Medres is totally dependent on the medical scheme / administrator and may include financial information pertaining to the payment,partial payment or non-payment of claims or any first line rejections.
Actions to take:
» electronic Remittance Advice (eRA)
An eRA is an electronic file that contains the final claim payment information. This reflects details of the amounts allocated for payment to the practice as well as details of claim lines that have not been paid. The rejection codes and descriptions that indicate non-payment are included.
The eRA is automatically returned to the practice by MediSwitch and can be printed together with the feedback reports. eRA’s can also be accessed via WEBDesk. Note that you will no longer receive paper remittance advices from participating medical schemes / administrators.
Actions to take:
» To access the Medres and eRA via WEBDesk:
The report will display as follows:
You have an option to either print the report or export to Excel/PDF by selecting one of the following tabs:
Should you have any further queries regarding Medres, please contact our call centre toll free on 0800 111 703 for further assistance.
- Yolandi de Mon
The Medres is returned via MediSwitch by participating medical schemes / administrators to provide the practice with prompt notification of rejected claims during the initial adjudication process as well as claims that are accepted for further processing (interim report).
The Medres report is automatically returned to the practice by MediSwitch and can be printed together with the feedback reports. Practices can also access their Medres reports via WEBDesk. The detail contained in the Medres is totally dependent on the medical scheme / administrator and may include financial information pertaining to the payment,partial payment or non-payment of claims or any first line rejections.
Actions to take:
- Act on rejected claims, correct and resubmit immediately.
- Claims indicated for partial payment: adjudicate and assign to patient liable and submit a statement to the patient.
» electronic Remittance Advice (eRA)
An eRA is an electronic file that contains the final claim payment information. This reflects details of the amounts allocated for payment to the practice as well as details of claim lines that have not been paid. The rejection codes and descriptions that indicate non-payment are included.
The eRA is automatically returned to the practice by MediSwitch and can be printed together with the feedback reports. eRA’s can also be accessed via WEBDesk. Note that you will no longer receive paper remittance advices from participating medical schemes / administrators.
Actions to take:
- The payment information returned on the eRA should be allocated and reconciled against the original claim lines.
- Act on the rejected unpaid claims immediately, correct where necessary and resubmit the claim to the medical scheme where applicable.
- When claims have been partially paid e.g. the patients savings is depleted, mark this as patient liable and submit statements to the patient.
» To access the Medres and eRA via WEBDesk:
- Log onto WEBDesk via www.mediswitch.co.za
- From the WEBDesk menu, under Claims Online, select the tab Medres / eRA
The report will display as follows:
You have an option to either print the report or export to Excel/PDF by selecting one of the following tabs:
Should you have any further queries regarding Medres, please contact our call centre toll free on 0800 111 703 for further assistance.
- Yolandi de Mon