eClaims Queries

When an eClaim is sent Panacea keeps a copy of all information related to the eClaim, including the following:

• Details of the patient, e.g. birth date, ICD codes
• Medical aid details, e.g. eClaims Destination, member's details, membership number, authorization
• Details of the treating and referring practitioners
• Switch and Assessment responses

The idea is to keep a complete "snapshot" of all related data as at the time the eClaim was sent.  Once the eClaim has been sent it cannot be modified.  This means that an accurate history is available should you wish to query the eClaim at a later stage.

There are a number of ways to query eClaims after they have been sent:

• Click eClaims - eClaim Query on Panacea's menu.  This is explained in more detail below.
• Click the eClaims button when you are on the Accounts tab .  This will show all eClaims for that account.
• When on the Transactions tab  click on the  button next to an invoice.  This will show eClaims that have been sent for that invoice.  (Note: more than one eClaim can be sent for an invoice because the eClaim might have been rejected, corrected and resent.)

When you click eClaims - eClaim Query on Panacea's menu the eClaims Query tab is displayed.  You can enter a batch number and / or an account number, then click Query.  Panacea will then search for matching eClaims.

Note that the eClaims Query tab also contains Switch Responses  and Assessment Responses .  You can also right-click on an eClaim to see your available options.  For details on correcting and resending eClaims read the sections on Switch Responses  and Assessment Responses .