DHS Installation and Initial use

The additional EDI Module allows batches of claims to be created. These claims are then sent via your modem and phone line (internet access is not necessary) to a service provider - such as DHS. The service provider then processes and validates the claims and sends them on to the Medical Aids.

To use EDI, make sure that your diagnoses are set up using the valid ICD10 codes. A list of ICD10 codes can be found on the CD that came with your software, or on this website (See the Downloads section).

For information about DHS and EDI, please refer to your software documentation, or visit the Information section on this website.

Using DHS as a service provider

1. Ensure that you are registered with BHF and that the various Medical Aid funds have your PR no and banking details.

2. Obtain the correct registration forms for your discipline e.g. Physio/OT/Doctor etc. from DHS. To do this you need to contact your regional representative:

Note that the minimum monthly fee for all para-medical disciplines (e.g. Physio, Psychology, OT, Speech Therapy etc.) is R75pm + VAT, not R150 which is for Doctors and specialists. If you would like anything on the contract explained they should be able to do so.

3. Now DHS will install the QCOMM software on your computer. They may send a technician to do this or they will send you disks and help you to do the installation on the phone. While you are waiting you can get ready for them:

In MTM Medical Accounting Software, you will need to activate the relevant Medical Aids.

• Go to your list of Medical Aids. For each one that is a valid EDI code (e.g. 125 Discovery), double click on it and click on the QEDI checkbox to activate it.

NB: Regardless of what you may be told, the codes must NOT have a P after them. Discovery is 125, not 125P.

• If you have treatments on your system that have already been submitted as paper statements, you need to mark them so that they will not get sent again. If not, you can ignore this step. In the software, click on the EDI menu -> Mark as Sent/Unsent. Change the date to the date that you last printed accounts, and mark all these old treatments as Sent. You will not need to do this again - in future any treatments you send will be marked automatically.

4. It is important that whoever does the installation also puts a shortcut on your Windows desktop that you can use to send claims AND receive feedback. Ideally this shortcut should be named something like "Send EDI claims & Receive feedback".

If the installation has already been done and there is no such shortcut on your desktop, create it yourself as follows:

• Click: Start button -> Programs -> Windows Explorer (Or hold the Windows key on your keyboard and press E)
• Search for a folder called QEDI in the directory tree.
• In the QEDI folder look for EDI.BAT or just EDI, of type MS-DOS Batch File.
• Right click on it and select Send To... -> Desktop (create shortcut) . Now you will have a file called "shortcut to EDI" on your desktop (you may close Windows Explorer)
• Select the shortcut (single left-click) and press F2 on your keyboard to rename it (or right click the shortcut and click Rename). Name the shortcut "Send EDI claims & Receive feedback".

5. To create your first batch of claims, click on EDI menu -> New Batch in the MTM Software. A list of claims to go will be presented. Click on the Print button to print the batch. Then click on the Create Batch button and then Close. Your claims are now in a file called export.dat in the "LIVEEDI" folder

6. Close the Medical Accounting Software and double click on the "Send EDI claims & Receive feedback" Icon on your desktop. Your claims will be sent.

7. Repeat steps 5 and 6 for subsequent batches. When you send your claims in Step 6, it should automatically print a feedback report that will show if any claims have been rejected. If you do not receive feedback reports, it is important that you sort this problem out, as claims may go stale. First ensure that you are running the correct "send claims" shortcut described in Step 4. If you are running the ordinary QCOMM software you will not get feedback. If everything seems to be in order but there is still no feedback, call the DHS help line. 0800 111 703

8. To resubmit rejected claims: First correct any errors on the patient account (e.g. Date of birth, Medical Aid number etc). Then on every treatment line that you need to resubmit, press the Q key on your keyboard. If you right click on the line it will tell you whether it is sent or unsent. You want it to read "not sent" so that it will be sent again.

9. If your patient's Medical Aid is not on the list it may be that it has changed its name. E.g.: Bankmed is now Equilibrium, Meddent is now Omni, Global is now Natalmed. Check with the Medical Aid or DHS to find out if there is an EDI code for it, before adding your own non-EDI code.

DHS run regular training courses free of charge that are helpful in learning how best to input your data. They also provide email and internet access at a very competitive rate.