Claims Import – Returned Files

To save time double reconciling payments, FYDO can produce a file with the exceptions and payment data, so that it can be imported back into your main system.

We can produce these files in XML format.
Note – nothing is returned back for Patient Claims.

Exception Statement

XML

Each item is export in the exception file, not just items that were rejected or paid a different amount.

Batch Number
External Servicing Dr Id
Claim Date
Total Paid i.e. for the entire batch
Voucher/Invoice Information
- Id
  - VVSS, the first 2 digits (VV) represent the voucher position within a batch and the next 2 digits (SS) represent the service position within the voucher
- External Patient Id
- External Invoice Id
- Patient Surname
- Patient First name
- Patient Medicare Number
- Medicare Flag
  - A – Patient identification has been amended
  - I – Patient medicare issue number changed
  - C – Patient medicare number changed
  - W – Patient card used will expire shortly
  - S – Patient card expired. Future services may be rejected
  - X – Old Medicare issue number for patient. Future services may be rejected
  - empty – no change
- Veterans Number
- Veterans Flag
  - A – Patient identification has been amended
  - C – Patient veterans number change
  - empty – no change
- Item Number
- Date of Service
- Amount Paid
- Exception Code
- Explanation Text
- Medicare Benefit (only provided when an ECLIPSE claim)
- Health Fund Benefit (only provided when an ECLIPSE claim)
- Health Fund Exception Code (only provided when an ECLIPSE claim)
- Health Fund Explanation Text (only provided when an ECLIPSE claim)

Payment File

XML

Batch Number
External Servicing Dr Id
Claim Date
Total Claim Amount Paid
Run Date
Run Number
Voucher Information
- Id
  - VVSS, the first 2 digits (VV) represent the voucher position within a batch and the next 2 digits (SS) represent the service position within the voucher
- External Patient Id
- External Invoice Id
- Patient Surname
- Patient First Name
- item Number
- Date of Service
- Amount Paid

Notes

External Doctor ID / External Patient ID / External Invoice ID – As long as this was provided when the data was imported, then we can include this when these export files are created.