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Companies

In Panacea 7 a company is any non-human entity.  Typically, this would include the following:

  • Medical aids
  • Other funders such as the WCA Commissioner and CompSol
  • Employers (used in Injury on Duty cases)

In Panacea the generic term "funder" is used to describe a company that may fund (or pay) an account.  This generally refers to medical aids, but can also include non-medical aid funders such as the WCA commissioner and CompSol .

Below is an example of a company:

Notice that the telephone number has "auto" in the description.  "Auto" indicates that the telephone number was supplied by the switch (Datamax) and will be updated automatically if it changes.  It is generally not necessary to enter telephone numbers or addresses for funders that are "eClaims live".  You can, however, add your own telephone numbers and addresses if you like.

Note the Is a funder? checkbox.  This indicates that the company is a medical funder.  When checked (ticked) the Funder settings, Billing settings and Statement settings tabs will be available, otherwise they will be hidden.

Funder settings Tab

Funder Type
This can be either Medical Aid, Injury on Duty or Private.  This matches the different account types.

eClaims Destination
This is a code, like an email address, that is used by the switch to route claims electronically to this funder.  The list of available codes are provided by Datamax.

eClaims Option
This tells Panacea when to send claims for patients using this funder.  The options are:

  • Send each claim immediately: the claim will be sent immediately after capturing the invoice.  This is very useful for funders that have realtime assessment capability.
  • Send claims in batches: the claim will be placed (with other claims) into a "batch", which can be sent when you are ready - usually at the end of the day.  This option provides more opportunity to check and correct your work.
  • Do NOT send electronically: this effectively disables eClaims for this funder.
  • Default: this setting tells Panacea to use the practice configuration when deciding how to send a claim.  This is the preferred setting unless you have specific reasons for choosing otherwise.

Dependant No. required
Some medical aids require each patient's dependant number to be provided on claims.  This is usually a two-digit number, e.g. 00, 01 etc.  Check this checkbox  if you wish Panacea to ensure that dependant numbers are supplied for patients on this funder.

Authorization required
Check this checkbox  to indicate to Panacea that this funder requires an authorization code before services are rendered.

Referring doctor required
Check this checkbox  to indicate to Panacea that this funder requires the patient to be referred by a doctor.  Panacea will ensure that the referring doctor's details are provided on the claim.  The referring doctor's details are captured on the patient's case .

Billing settings tab

Pricelists
If you wish to override the practice default pricelists you can set different pricelists on the funder.  This is useful where a medical aid pays their own rate, e.g. Discovery.  By setting the funder's pricelist on the funder's record Panacea will automatically charge that pricelist when billing patient's on this funder.  See Pricelists Defaults  for details on how Panacea will determine which pricelist to use if you set this field to Default.

Split billing
You can set a default split billing value here which will apply to all accounts where this funder is specified.  See Split Billing Defaults  for details on what Panacea will do if you set this field to Default.

 

 

Statement settings tab

Statement messages
This field enables you to set statement messages that are specific to this funder.  See Statement Messages Defaults  for details on what messages will be used if you set this field to Default.

Referral info
This field enables you to determine if the referring doctor's information is displayed on statements.  Certain medical aids require this information.  The options are:

  • Show: this will display the referring doctor's info on the statement
  • Don't Show: the referral info will not be shown
  • Default: see Referral Info Defaults

Tariff code prefixes
This field determines if prefixes will be printed on statements.  See Tariff Code Prefixes Defaults  for details on what Panacea will do if this field is set to Default.

 
 
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