OA Processing Kopo
Bukana ea Mosebelisi
OA Processing Kopo
TŠEBELETSO POLELO
Ho tsebahatsa, kabo le ho kopitsoa ha bukana ena ho lumelletsoe, leha ho le joalo, liphetoho linthong tse fumanoang tataisong ena li ka etsahala neng kapa neng ntle le tsebiso. Sepheo se reriloeng le tšebeliso ea tataiso ena ke ho fana ka tlhahisoleseding e mabapi le Kleimi ea Tlhokomelo ea Bophelo bo Botle: Institutional (837I).
Office Ally, Inc. e tla bitsoa OA ho pholletsa le tataiso ena.
SEBAKA
Tokomane ena ea Tšebelisano ho Litaelo tsa Ts'ebetsong tsa ASC X12N le liphoso tse amanang le tsona tse amohetsoeng tlas'a HIPAA li hlakisa le ho hlakisa litaba tsa data ha ho fapanyetsanoa data ea bophelo bo botle ba elektroniki le OA. Phetiso e ipapisitseng le tokomane ena e tsamaisanang le eona, e sebelisitsoeng hammoho le X12N Implementation Guides, e tsamaellana le syntax ea X12 le litataiso tseo.
Tataiso ena ea Bolekane e reretsoe ho fetisa tlhahisoleseling e ka har'a moralo oa Litataiso tsa Ts'ebetso tsa ASC X12N tse amohetsoeng hore li sebelisoe tlasa HIPAA. Bukana ea Tataiso ha ea rereloa ho fetisa tlhahisoleseling eo ka tsela efe kapa efe e fetang litlhoko kapa ts'ebeliso ea data e hlahisitsoeng ho Litaelo tsa Phethahatso.
Companion Guides (CG) e ka 'na ea e-ba le mefuta e' meli ea boitsebiso, litaelo tsa puisano ea elektronike le mokhatlo oa khatiso (Litaelo tsa Lipuisano / Khokahano) le tlhahisoleseding e eketsehileng bakeng sa ho etsa litšebelisano bakeng sa mokhatlo oa khatiso ha o ntse o netefatsa hore o lumellana le ASC X12 IG e amanang le eona (Transaction Instructions). Ekaba karolo ea Khokahano / Khokahano kapa karolo ea Taelo ea Transaction e tlameha ho kenyelletsoa ho CG e 'ngoe le e 'ngoe. Likarolo li ka hatisoa e le litokomane tse arohaneng kapa e le tokomane e le 'ngoe.
Karolo ea Lipuisano / Khokahano e kenyelelitsoe ho CG ha mokhatlo o hatisang o batla ho fetisa boitsebiso bo hlokahalang ho qala le ho boloka phapanyetsano ea puisano.
Karolo ea Transaction Instruction e kenyelelitsoe ho CG ha mokhatlo oa khatiso o batla ho hlakisa litaelo tsa IG bakeng sa ho fana ka litšebelisano tse khethehileng tsa elektronike. Likahare tsa karolo ea Transaction Instruction li lekantsoe ke litokelo tsa litokelo tsa molao tsa ASCX12 le polelo ea Tšebeliso e Ntle.
LIEKETSENG
1.1 Boemo
Tokomane ena ea Companion e ts'ehetsa ts'ebetsong ea ts'ebeliso ea ts'ebetso ea batch.
OA e tla amohela litlhahiso tse kenang tse hlophisitsoeng hantle ka mantsoe a X12. The files e tlameha ho lumellana le litlhaloso tse hlalositsoeng tokomaneng ena ea motsoalle hammoho le tataiso ea ts'ebetsong ea HIPAA e tsamaellanang.
Lisebelisoa tsa OA EDI li tla hlophisa maemo ana 'me li hane files tse tsoileng tseleng.
Tokomane ena e tsamaisanang le eona e tla hlakisa tsohle tse hlokahalang ho tsamaisa EDI bakeng sa transaction ena e tloaelehileng. Sena se kenyeletsa:
- Lintlha tse mabapi le lihokelo tsa likhokahano
- Litokisetso tsa mekhoa ea tlhahiso
- Litlhaloso mabapi le transactions
1.2 Ho fetaview
Tataiso ena ea molekane e babatsa tataiso ea ts'ebetsong ea ASC X12N e amohetsoeng hajoale ho tsoa ho HIPAA.
Tataiso ena e tsamaisanang le eona e tla ba koloi eo OA e e sebelisang le balekane ba eona ba khoebo ho tsoela pele ho tšoaneleha tataiso e amohetsoeng ea HIPAA. Tataiso ena e tsamaisanang le eona e lumellana le tataiso ea ts'ebetsong ea HIPAA e lumellanang le lintlha tsa data le khoutu e beha litekanyetso le litlhoko.
Lintlha tsa data tse hlokang tumellano le kutloisiso li tla hlalosoa ho tataiso ena ea molekane. Mefuta ea tlhahisoleseling e tla hlakisoa ka har'a komporo ena ke:
- Litšoaneleho tse tla sebelisoa ho tsoa ho litataiso tsa ts'ebetsong tsa HIPAA ho hlalosa lintlha tse itseng tsa data
- Likarolo tsa maemo le lintlha tsa data tse tla sebelisoa ho khotsofatsa maemo a khoebo
- Ho batla molekane profile tlhahisoleseling molemong oa ho tseba hore na re hoeba le mang bakeng sa phetiso e fapanyetsanoang
1.3 Litšupiso
ASC X12 e phatlalatsa litataiso tsa ts'ebetsong, tse tsejoang e le Litlaleho tsa Tekheniki tsa Mofuta oa 3 (TR3's), tse hlalosang litaba tsa data le litlhoko tsa ho lumellana le ts'ebetsong ea tlhokomelo ea bophelo ea li-transaction tsa ASC X12N/005010. TR3 e latelang e boletsoe bukeng ena:
- Kopo ea Bophelo bo Botle: Setheo - 8371 (005010X223A2)
TR3 e ka rekoa ka Washington Publishing Company (WPC) ho http://www.wpc:-edi.com
1.4 Boitsebiso bo Eketsehileng
Electronic Data Interchange (EDI) ke phapanyetsano ea khomphutha ho ea ho komporo ea data e hlophisitsoeng ea khoebo lipakeng tsa balekane ba khoebo. Sistimi ea khomphutha e hlahisang transaction e tlameha ho fana ka tlhaiso-leseling e felletseng le e nepahetseng ha sistimi e amohelang litšebelisano e tlameha ho khona ho hlalosa le ho sebelisa tlhaiso-leseling ka sebopeho sa ASC X12N, ntle le ho kenella ha motho.
Lichelete li tlameha ho romelloa ka mokhoa o ikhethileng o tla lumella komporo ea rona ho fetolela data. OA e ts'ehetsa litšebelisano tse tloaelehileng tse amohetsoeng ho tsoa ho HIPAA. OA e boloka basebetsi ba inehetseng ka sepheo sa ho nolofalletsa le ho sebetsana le phetiso ea X12 EDI le balekane ba eona ba khoebo.
Ke sepheo sa OA ho theha likamano tsa balekane ba khoebo le ho tsamaisa EDI ho fapana le phallo ea lintlha tsa pampiri neng kapa neng ha ho khonahala.
REA QALA
Ho Office Ally, re utloisisa hore na ho bohlokoa hakae ho ba le mokhoa o bonolo oa ho o sebelisa, o sebetsang hantle, le o hlophisitsoeng molemong oa hau. U tla fumana litefo tse fihlang ho makhetlo a 4 ka potlako ha u romella ka mokhoa oa elektroniki, 'me u tla tseba ka mor'a lihora tse seng kae haeba bothata bo hlaha ka e 'ngoe ea likopo tsa hau.
Melemo ea Office Ally:
- Kenya Litlaleho ka Elektronike ho Balefi ba likete MAHALA
- Ha ho Likonteraka tse lokelang ho saena
- Seta MAHALA le Koetliso
- Tšehetso ea bareki ea 24/7 MAHALA
- Ha ho sa na li-EOB tsa pampiri! Electronic Remittance Advice (ERA) e fumaneha bakeng sa batho ba khethang ho lefa
- Sebelisa Software ea hau e teng ea Practice Management ho kenya likopo ka mokhoa oa elektroniki
- Kakaretso ea Litlaleho tsa Kakaretso
- Khalemelo ea Litlaleho Inthaneteng
- Tlaleho ea Inventory (setoko sa litlaleho tsa histori)
Selelekela sa video sa Setsi sa Ts'ebeletso sa Office Ally se fumaneha mona: Selelekela sa Setsi sa Ts'ebeletso
2.1 Ngoliso ea Mofani
Baipelehi (Mofani/Bili/ba jwalo.) ba tlameha ho ingodisa le Office Ally e le hore ba romele dikopo ka mokgwa wa elektroniki. U ka ingolisa ka ho ikopanya le Lefapha la Ngoliso la OA ho 360-975-7000 Khetho ea 3, kapa ka ho qala ho ngolisa inthaneteng MONA.
Lethathamo la ho ingolisa le ka fumanoa leqepheng le latelang.
OA Registration Check Ke.
- Feletseng Ngoliso ea Marang-rang (kapa letsetsa Lefapha la Ngoliso la OA @ 360-975-7000 Khetho ea 3)
- Saena OA's Authorization Sheet
- Review, saena, 'me u boloke li-OA Office-Ally-BAA-4893-3763-3822-6-Final.pdf (officeally.com) bakeng sa lirekoto tsa hau
- Fumana OA e abetsoeng Lebitso la Mosebelisi le sehokelo sa ho kenya phasewete
- Etsa lenaneo la koetliso ea MAHALA (ha ho hlokahala)
- Review Motataisi oa motsoalle oa OA
- Review OA tse Office Ally Ally Available Payers ho fumana ID ea Pager hammoho le litlhoko tsa ngoliso ea EDI
- Ho phethela teko le botjhaview litlaleho tsa karabelo (e hlokoa feela bakeng sa barekisi ba software ea motho oa boraro)
- Qala ho kenya likopo tsa tlhahiso!
FILE PUSELETSO TS'OANE
3.1 E amohetsoe File Mefuta
Office Ally e ka amohela le ho sebetsana le tse latelang file mefuta:
- HCFA, CMS1500, UB92, le UB04 Image Files
- ANSI X12 8371, 837P, le 837D files
- HCFA NSF Files HCFA Tab Delimited Files (Sebopeho se tlameha ho ikamahanya ka thata le lintlha tsa OA. Ikopanye le Tšehetso bakeng sa lintlha.)
3.2 E amohetsoe File Keketso
Ka mokhoa o ts'oanang, Office Ally e ka amohela files tse nang le tse ling tsa tse ka tlase file katoloso ea mabitso:
| TXT | Dat | Zip | Ecs | Sheba |
| Hcf | Lst | Ls | Pm | Tsoa |
| Clm | 837 | Nsf | Pmg | Cnx |
| Pgp | Fil | Csv | Mpn | tab ya |
3.3 File Liphetoho tsa Sebopeho
Ho bohlokoa hore o tsoelepele ho romella se tšoanang file sebopeho ha o romella kopo files ho Ofisi ea Ally. Haeba oa hau file liphetoho tsa sebopeho ka lebaka la liapdeite tsa sistimi, likhomphutha tse ncha, kapa likhetho tse fapaneng tsa mefuta, the file e ka hloleha.
Haeba o hloka ho ntlafatsa file ea file e romelloa ho Office Ally, ka kopo ikopanye le OA ho 360-975-7000 Khetho ea 1 'me u tsebise Moemeli oa Tšebeletso ea Bareki hore u hloka ho ba le ea hau file sebopeho se ntlafalitsoe.
TEKO LE OFFICE ALLY
Ho etsa bonnete ba hore ho ba le phetoho e bonolo ea ho romella ka mokhoa oa elektroniki ka Office Ally, ho khothaletsoa hore tlhahlobo e phetheloe bakeng sa batho bohle ba romellang mananeo a mang.
Teko ea ho Qetela-Qetellong ha e fumanehe bakeng sa bohle ba lefang ('me e phethoa feela ka kopo ea molefi); leha ho le joalo, u ka etsa liteko hangata kamoo u ka ratang ka OA ka kotloloho.
E kgothaletswa hore teko file e nang le likopo tse 5-100 li romelloe bakeng sa tlhahlobo. Likopo tsa liteko li tlameha ho kenyelletsa likopo tse fapaneng, tse ikarabellang bakeng sa mefuta e fapaneng ea maemo kapa maemo ao u sebetsanang le 'ona khafetsa (Ambulance, NDC, Inpatient, Outpatient, joalo-joalo).
Ka mor'a tlhahlobo ea hau file e rometsoe le ho sebetsoa, Ofisi ea Ally e khutlisa tlaleho e hloaeang likopo tse atlehileng ho hlahlojoa le tseo e kanna eaba li hlolehile.
4.1 Teko File Litlhoko tsa ho Reha Mabitso
Lentsoe OATEST (kaofela lentsoe le le leng) le tlameha ho kenyelletsoa tlhahlobo file lebitso e le hore Office Ally e lemohe e le teko file. Haeba e file ha e na lebitso la bohlokoa le hlokahalang (OATEST), the file e tla sebetswa tikolohong ya rona ya tlhahiso ho sa tsotelehe hore na ISA15 e setetswe ho 'T'. Ka tlase ke exampliteko tse amohelehang le tse sa amoheleheng file mabitso:
AMOHELA: XXXXXX.OATEST.XXXXXX.837
AMOHELA: OATEST XXXXXX_XXXXX.txt
HA E amoheloe: 0A_TESTXXXX>C
HA E amoheloe: TEKO XXXXXX_XXXXX.837
Teko files e ka romelloa ka file kenya kapa phetiso ea SFTP. Ha o fana ka teko files ka SFTP, lebitso la sehlooho la mofuta oa tleleime le lona le tlameha ho kenyelletsoa ho file lebitso (ke hore 837P/8371/837D).
TŠEBELETSO TS'OANELO
Office Ally e fana ka tse peli file mekhoa ea ho fapanyetsana bakeng sa barekisi ba lihlopha:
- SFTP (Sireletsehile File Phetisetso Protocol)
- Ofisi ea Ally e Sireletsehile Websebaka
5.1 SFTP — Sireletsa File Phetisetso Protocol
Taelo ea ho seta
Ho kopa khokahano ea SFTP, romella lintlha tse latelang ka lengolo-tsoibila ho Sipporteofficeallu.com:
- Office Ally Username
- Lebitso la Lebitso
- Ikopanye le Imeile
- Software Name (haeba e le teng)
- Mefuta ea Litlaleho e Rometsoe (HCFA/UB/ADA)
- Fumana litlaleho tsa 999/277CA? (Ee kapa che)
Hlokomela: Haeba u khetha 'Che', ho tla khutlisoa feela litlaleho tsa mongolo oa Office Ally.
Lintlha tsa Khokahano
URL Aterese: ftp10officeally.com
Boema-kepe ba 22
SSH/SFTP E nolofalitsoe (Haeba u botsoa ho Cache SSH nakong ea logon, tobetsa 'E')
Filee kentsoeng ho Office Ally ka SFTP e tlameha ho behoa foldareng ea "inbound" bakeng sa ts'ebetso. Tsohle SFTP e tsoa files (ho kenyeletsoa le 835's) ho tsoa ho Office Ally e tla fumaneha bakeng sa ho khutlisoa ka har'a foldara e "tsoang".
SFTP File Litlhoko tsa ho Reha Mabitso
Likopo tsohle tse kenang filee rometsoeng ka SFTP e tlameha ho ba le le leng la mantsoe a sehlooho a latelang ho file lebitso la ho khetholla mofuta oa likopo tse rometsoeng: 837P, 8371, kapa 837D
Bakeng sa mohlalaample, ha o fana ka tleleime ea tlhahiso file e nang le likopo tsa setheo: drsmith_8371_claimfile_10222022.837
5.2 Ofisi ea Ally Sireletsehile Websebaka
Latela mehato e ka tlase ho kenya kopo file sebelisa tšireletso ea Office Ally websebaka.
- Kena ho www.officeally.com
- Tsamaea holim'a "Litlhaloso tsa Kenya"
- Tobetsa ho kenya file ho ipapisitsoe le mofuta oa tleleime ea hau (ke hore, "Upload Professional (UB/8371) File”)
- Tobetsa "Khetha File”
- Batla bakeng sa hau file ebe o tobetsa "Open"
- Tobetsa "Upload"
Ha u se u kentse, u tla fumana leqephe la netefatso la ho kenya le hau FilelD nomoro.
Litlaleho tsa likarabo li tla fumaneha nakong ea lihora tse 6 ho isa ho tse 12 ho "Download File Kakaretso” karolo ea websebaka.
MOKHOA OA PUISANO
6.1 Tšebeletso ea Bareki
| Matsatsi a Teng: | Mantaha ho isa Labohlano |
| Linako Tse Teng: | 6:00 hoseng ho isa 5:00 pm PST |
| Mohala: | 360.975.7000 Khetho ea 1 |
| Lengolo-tsoibila: | support@officeally.com |
| Fax: | 360.896-2151 |
| Live Chat: | https://support.officeally.com/ |
6.2 Tšehetso ea Theknoloji
| Matsatsi a Teng: | Mantaha ho isa Labohlano |
| Linako Tse Teng: | 6:00 hoseng ho isa 5:00 pm PST |
| Mohala: | 360.975.7000 Khetho ea 2 |
| Lengolo-tsoibila: | support@officeally.com |
| Live Chat: | https://support.officeally.com/ |
6.3 Thuso ea Boingoliso
| Matsatsi a Teng: | Mantaha ho isa Labohlano |
| Linako Tse Teng: | 6:00 hoseng ho isa 5:00 pm PST |
| Mohala: | 360.975.7000 Khetho ea 3 |
| Lengolo-tsoibila: | support@officeally.com |
| Fax: | 360.314.2184 |
| Live Chat: | https://support.officeally.com/ |
6.4 Koetliso
| Kemiso: | 360.975.7000 Khetho ea 5 |
| Lithuto tsa Lifitio: | https://cms.officeally.com/Pages/ResourceCenter/Webinars.aspx |
TAOLI LIKHATLO/LIEFOLOPO
Karolo ena e hlalosa ts'ebeliso ea OA ea phapanyetsano (ISA) le sehlopha sa tšebetso (karolo ea taolo ea GS. Hlokomela hore litlatsetso ho Office Ally li lekanyelitsoe ho phapanyetsano e le 'ngoe (ISA) le sehlopha se le seng sa tšebetso (GS) ka nako e le ngoe. file. Files e kanna ea ba le li-transaction sets tse fihlang ho 5000 (ST).
7.1 ISA-IEA
| Lintlha | Tlhaloso | Melao e Sebelisitsoeng | Maikutlo |
| ISA01 | Authorization Qualifier | 0 | |
| ISA02 | Khoutu ea tumello | ||
| ISA03 | Tshireletso Qualifier | 0 | |
| KE SA04 | Boitsebiso ba Tšireletso | ||
| ISA05 | Mofani oa Moromeli | 30 kapa ZZ | |
| ISA06 | ID ea moromelli | ID ea motho ea rometseng eo u e khethang. ID ea Lekhetho e atile haholo. | |
| ISA07 | Mofani oa Moamoheli | 30 kapa ZZ | |
| ISA08 | ID ea moamoheli | 330897513 | ID ea Lekhetho la Ofisi ea Ally |
| ISA11 | Pheta-pheta Searohanyi | A | Kapa karohano ea khetho ea hau |
| ISA15 | Sesupo sa Tšebeliso | P | Tlhahiso File Ho etsa liteko, romella "OATEST" ho filelebitso. |
7.2 GS-GE
| Lintlha | Tlhaloso | Melao e Sebelisitsoeng | Maikutlo |
| GS01 | Khoutu ea ID e sebetsang | ||
| G502 | Baromeli Khoutu | Mofani oa khoutu eo u e khethileng. ID ea Lekhetho e atile haholo. | |
| GS03 | Khoutu ea moamoheli | OA kapa 330897513 | |
| GS08 | Khoutu ea ID ea Indasteri ea Phatlalatso | 005010X223A2 | Setheo |
OFFICE ALLY MELAO E KHETHEHILENG EA Kgwebo LE MELAO
E latelang file litlhaloso li nkiloe ho Tataiso ea Ts'ebetsong ea 837 X12. Sepheo ke ho fana ka tataiso mabapi le loops le likarolo tse itseng tse bohlokoa ho sebetsana le likopo ka mokhoa oa elektroniki. Sena ha se tataiso e felletseng; tataiso e felletseng ea fumaneha bakeng sa ho rekoa ho tsoa Washington Publishing Company.
| Lintlha tsa Mofani Loop 1000A- NM1 |
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| Sepheo sa karolo ena ke ho fana ka lebitso la motho kapa mokhatlo o romellang lengolo la file | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | 41 | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 1 kapa 2 | 1 = Motho 2 = Motho eo e seng Motho |
| NM103 | Lebitso la mokhatlo (kapa qetello). | 1/35 | ||
| NM104 | Lebitso la Pele | 1/35 | Boemo; Ho hlokahala feela haeba NM102 = 1 | |
| NM108 | Identification Code Qualifier | 1/2 | 46 | |
| NM109 | Khoutu ea Boitsebiso | 2/80 | ID ea motho ea rometseng eo u e khethang (ID ea Lekhetho e tloaelehile) | |
| Boitsebiso ba Moamoheli Loop 10008 - NM 1 |
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| Sepheo sa karolo ena ke ho fana ka lebitso la mokhatlo oo u o romelang | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | 40 | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 2 | |
| NM103 | Lebitso la Mokhatlo | 1/35 | OFISI MOTSOALLE | |
| NM108 | Identification Code Qualifier | 1/2 | 46 | |
| NM109 | Khoutu ea Boitsebiso | 2/80 | 330897513 | ID ea Lekhetho la OA |
| Tlhahisoleseding ea Bafani ba Litefiso Loop 2010AA— NM1, N3, N4, REF |
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| Sepheo sa karolo ena ke ho fana ka lebitso, aterese, NPI, le ID ea Lekhetho bakeng sa mofani oa tefo. | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | 85 | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 2 | 2 = Motho eo e seng Motho |
| NM103 | Lebitso la Mokhatlo (kapa Sefemane). | 1/60 | ||
| NM108 | Identification Code Qualifier | 1/2 | XX | |
| NM109 | Khoutu ea Boitsebiso | 2/80 | Nomoro ea NPI ea linomoro tse 10 | |
| N301 | Aterese ea Seterata ea Bafani ba Tefiso | 1/55 | Ho hlokahala Aterese ea Sebaka sa Hao. Se ke oa romela PO Box. | |
| N401 | Motse oa Mofani oa Tefiso | 2/30 | ||
| N402 | Naha ea Bafani ba Litefiso | 2/2 | ||
| N403 | Zip ea mofani oa litefiso | 3/15 | ||
| RETS'ELISITSOE | Reference Identification Qualifier | 2/3 | El | El= ID ea Lekhetho |
| REF02 | Boitsebiso ba Reference | 1/50 | ID ea Lekhetho ea linomoro tse 9 | |
| Litaba tsa Subscriber (Insured). Loop 2010BA - NM1, N3, N4, DMG |
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| Sepheo sa karolo ena ke ho fana ka lebitso, aterese, ID ea setho, DOB, le bong ba motho ea ngolisitseng (inshorense) | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | IL | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 1 | |
| NM103 | Subscriber Lebitso | 1/60 | ||
| NM104 | Subscriber Lebitso la Pele | 1/35 | ||
| NM108 | Identification Code Qualifier | 1/2 | MI | |
| NM109 | Khoutu ea Boitsebiso | 2/80 | Nomoro ea ID ea Setho | |
| N301 | Subscriber Street Address | 1/55 | ||
| N401 | Subscriber City | 2/30 | ||
| N402 | Subscriber State | 2/2 | ||
| N403 | Moreri Zip | 3/15 | ||
| DMG01 | Sekhetho sa Sebopeho sa Nako ea Letsatsi | 2/3 | 8 | |
| DMG02 | Letsatsi la Tsoalo la Ngoliso | 1/35 | Mofuta oa YYYYMMDD | |
| DMG03 | Tekano ea Moreri | 1/1 | F, M, kapa U F = Mosadi |
M = Monna U = Tse sa tsejoeng |
| Litaba tsa Molefi Loop 201088 - NM1 |
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| Sepheo sa karolo ena ke ho fana ka lebitso la molefi le ID eo tleleime e lokelang ho romelloa ho (mofi ea lefshoang) Ka kopo sebelisa li-ID tsa motho ea lefang tse thathamisitsoeng Lethathamong la Balefi ba Office Ally ho etsa bonnete ba hore u tsamaea ka tsela e nepahetseng. |
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| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | PR | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 2 | |
| NM103 | Lebitso la Ea Lefisitsoeng | 1/35 | ||
| NM108 | Identification CodeQualifier | 1/2 | PI | |
| Nm1O9 | 5-Digit Molefi ID | 2/80 | Sebelisa ID ea molefi e thathamisitsoeng lethathamong la Office Ally Payer. | |
| Lintlha tsa Mokuli (Maemo) Loop 2010CA— NM1, N3, N4, DMG |
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| Sepheo sa karolo ena ke ho fana ka lebitso la mokuli - haeba le fapane le motho ea ngolisitseng (ea itšetlehileng) | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | QC | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 1 | |
| NM103 | Lebitso la Mokuli | 1/60 | ||
| NM104 | Lebitso la Mokuli | 1/35 | ||
| N301 | Aterese ea Seterata ea Mokuli | 1/55 | ||
| N401 | Motse oa mokuli | 2/30 | ||
| N402 | Naha ea mokuli | 2/2 | ||
| N403 | Zip ea mokuli | 3/15 | ||
| DMG01 | Sekhetho sa Sebopeho sa Nako ea Letsatsi | 2/3 | D8 | |
| DMG02 | Letsatsi la Tsoalo la Mokuli | 1/35 | Mofuta oa YYYYMMDD | |
| DMG03 | Bong ba Mamello | 1/1 | F, M, kapa U | F = Mosadi M = Monna U = Tse sa tsejoeng |
| Ho ba teng ho Boitsebiso ba Bafani Loop 2310A- NM1 |
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| Sepheo sa karolo ena ke ho fana ka lebitso le NPI ea mofani ea ikarabellang bakeng sa tlhokomelo ea meriana ea mokuli. | |||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo | |
| NM101 | Khoutu ea Sekhetho | 2/3 | 71 | ||
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 1 | 1= Motho | |
| NM103 | Ho Etela Lebitso | 1/60 | |||
| NM104 | Ho ea Lebitsong la Pele | 1/35 | |||
| NM108 | Identification Code Qualifier | 1/2 | XX | ||
| NM109 | Khoutu ea Boitsebiso | 2/80 | Nomoro ea NPI ea linomoro tse 10 | ||
| Lintlha tsa Bafani ba Ts'ebetso (Boemo) Loop 23108 - NM1 |
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| Sepheo sa karolo ena ke ho fana ka lebitso le NPI ea mofani ea ikarabellang bakeng sa ho etsa opereishene ea mokuli. | ||||
| Boemo | Tlhaloso | Min/Boholo | Boleng | Maikutlo |
| NM101 | Khoutu ea Sekhetho | 2/3 | 72 | |
| NM102 | Mofuta oa Mofuta oa Motheo | 1/1 | 1 | 1= Motho |
| NM103 | Ho Etela Lebitso | 1/60 | ||
| NM104 | Ho ea Lebitsong la Pele | 1/35 | ||
| NM108 | Identification Code Qualifier | 1/2 | XX | |
| NM109 | Khoutu ea Boitsebiso | 2/80 | Nomoro ea NPI ea linomoro tse 10 | |
LITEBOHO LE LITLALEHO
Office Ally e khutlisa likarabo tse latelang le mefuta ea tlaleho. Joalokaha ho boletsoe, likarabo tsa 999 le 277CA li hlahisoa feela bakeng sa tleleime filee rometsoe ka SFTP. Sheba Sehlomathiso sa A bakeng sa lethathamo la file ho reha mabitso a mabitso a amanang le karabo ka 'ngoe.
9.1 999 Teboho ya Phethahatso
Tokomane ea Teko ea Phethahatso ea EDI X12 999 e sebelisoa tlhokomelong ea bophelo bo botle ho fana ka netefatso ea hore file e amohetsoe. Kamohelo ea 999 e khutlisetsoa ho ea rometseng feela bakeng sa tleleime filee rometsoe ka SFTP.
9.2 277CA Kamohelo ea Kopo File Kakaretso
Sepheo sa EDI X12 277CA File Kakaretso ke ho tlaleha hore na tleleime e hanngoe kapa che kapa e amohetsoe ke Office Ally. Ke likopo tse amohelehang feela tse tla romelloa ho molefi bakeng sa ho sebetsa. Ena ke X12 e hlophisitsoeng file e lekanang le mongolo o hlophisitsoeng File Kakaretso Tlaleho.
9.3 277CA Boikoetliso ba Kamohelo ea Boemo ba EDI
Sepheo sa tlaleho ea Boemo ba EDI X12 277CA EDI ke ho fetisa hore tleleime e amohetsoe kapa e hannoe ke molefi. Ena ke X12 e hlophisitsoeng file e lekanang le mongolo o hlophisitsoeng oa Tlaleho ea Boemo ba EDI
9.4 File Kakaretso Tlaleho
The File Summary Report ke mongolo (.txt) o hlophisitsoeng file e bontšang hore na likopo li ile tsa amoheloa kapa tsa hanoa ke Office Ally. Likopo tse amohetsoeng li tla romelloa ho molefi bakeng sa ho sebetsa. Sheba Sehlomathiso sa B bakeng sa file litlhaloso tsa sebopeho.
9.5 Tlaleho ea Boemo ba EDI
Tlaleho ea Boemo ba EDI ke mongolo (.txt) o hlophisitsoeng file se sebedisoang ho hlahisa boemo ba tleleime ka mora hore se romelwe ho pager bakeng sa ho sebetsa. Likarabo tsa tleleime tse amohetsoeng ho tsoa ho pager li tla fetisetsoa ho uena ka mokhoa oa Tlaleho ea Boemo ba EDI. Sheba Sehlomathiso sa C bakeng sa file litlhaloso tsa sebopeho.
Ntle le litlaleho tsena tsa mongolo, o kanna oa kopa ho amohela Tlaleho ea Boemo ba CSV EDI. Tlaleho ea Boemo ba CSV EDI e na le likopo tse kenyellelitsoeng ho mongolo oa Tlaleho ea Boemo ba EDI file, hammoho le likarolo life kapa life tse ling tsa data tseo u li khethileng.
Bakeng sa lintlha tse ling le/kapa ho kopa khetho ena, ka kopo ikopanye le Tšehetso ea Bareki.
9.6 835 Keletso ea ho Remittance ea Elektronike
Office Ally e tla khutlisa EDI X12 835 files, hammoho le mofuta o hlophisitsoeng oa mongolo oa remit file. Sheba Sehlomathiso sa D bakeng sa file litlhaloso tsa sebopeho.
SEHLOMATHISO A – KARABELO EA OFFICE ALLY FILE LEBITSO LIKOPANO
| Litlaleho tsa Ofisi ea Ally le File Likopano Tsa ho Reha Mabitso | |
| File Kakaretso - Setsebi* | FS_HCFA_FILEID_IN_C.txt |
| File Kakaretso — Setheo* | FILEID_UBSUMMARY_YYYYMMDD.txt |
| Boemo ba EDI* | FILEID_EDI_STATUS_YYYYMMDD.txt |
| X12 999** | FILEID_E rometsoeFileLebitso_999.999 |
| X12 277CA – Setsebi (File Kakaretso)** | USERNAME_FILEID_HCFA_277ca_YYYYMMDD.txt |
| X12 277CA – Setheo (File Kakaretso)** | USERNAME_FILEID_UB_277ca_YYYYMMDD.txt |
| X12 277CA – Setsebi (Boemo ba EDI)** | FILEID_EDI_STATUS_HCFA_YYYYMMDD.277 |
| X12 277CA – Setheo (Boemo ba EDI)** | FILEID_EDI_STATUS_UB_YYYYMMDD.277 |
| X12 835 & ERA (TXT)** | FILEID_ERA_STATUS_5010_YYYYMMDD.zip (e na le 835 le TXT) FILEID_ERA_835_5010_YYYYMMDD.835 FILEID_ERA_STATUS_5010_YYYYMMDD.txt |
*Sheba Lihlomathiso B ho ea ho D bakeng sa File litlhaloso tsa sebopeho
**999/277CA ts'ebetso ea tlaleho e tlameha ho kopuoa mme e fumaneha feela bakeng sa filee rometsoe ka SFTP
SEHLOMATHISO B – FILE KAKARETSO – SEKOETE
Ka tlase ke examptse ling tsa Setheo File Kakaretso Tlaleho:
Litlaleho tsohle ka har'a File Li ile tsa amoheloa ke Ofisi ea Ally
Litsenyehelo tse ling ka har'a File Li ile tsa Amoheloa 'me tse ling li ile tsa Hanoa (li fosa) ke Ofisi ea Ally
Ka tlase ke tse file lintlha tsa sebopeho bakeng sa karolo ka 'ngoe ea likarolo tse ka kenyelletsoang ho File Kakaretso.
| FILE TS'ELISO TS'OANELO | ||
| Lebitso la Tšimo Qala Pos Bolelele ba Tšimo | ||
| KLEIMA# | 1 | 6 |
| BOEMO | 10 | 3 |
| KOPO ID | 17 | 8 |
| TAOLI NUM | 27 | 14 |
| MEDICAL REC | 42 | 15 |
| ID YA MOLWEDI | 57 | 14 |
| MOLWEDI (L, F) | 72 | 20 |
| TS'ELISO KAMELO | 95 | 12 |
| HO TLOHA LETSATSI | 109 | 10 |
| LITEKO TAXID | 124 | 10 |
| NPI / PIN | 136 | 11 |
| MOLEFI | 148 | 5 |
| PHOSO CODE | 156 | 50 |
| PHETHA TSEBISO | ||
| Lebitso la Tšimo Qala Pos Bolelele ba Tšimo | ||
| Boitsebiso | 1 | 182 |
| ID ea Kopo ea OA | 35 | 8 |
| OA File Lebitso | 55 | |
| LetsatsiProcessed | – | – |
| TAOLI NUM | – | |
Lintlha: 1. "-" e bontša hore sebaka sa ho qala le bolelele bo ka fapana ka lebaka la bolelele ba OA file lebitso 2. Likhoutu tsa phoso li arotsoe ka koma 'me li lumellana le kakaretso ea phoso sehloohong. 3. Haeba ACCNT# (CLM01) e le > linomoro tse 14, boemo ba ho qala ba PHYS.ID, PAYER, le ERRORRS bo tla lokisoa.
SEHLOMATHISO C – TLALEHO EA BOEMO BA EDI
Tlaleho ena e hlophisitsoeng e tšoana le ea File Kakaretso Tlaleho; leha ho le joalo, Tlaleho ea Boemo ba EDI e na le tlhaiso-leseling ea boemo e rometsoeng ho Office Ally ho tsoa ho molefi. Molaetsa ofe kapa ofe oo OA e o fumanang ho tsoa ho molefi o tla fetisetsoa ho uena ka mokhoa oa Tlaleho ea Boemo ba EDI.
Tlaleho ea Boemo ba EDI e tla hlaha mme e shebahale e ts'oana le ea khaleample bontšitsoeng ka tlase.
Hlokomela: Ka ED! Tlaleho ea Boemo, haeba likarabo tse ngata li ka khutla bakeng sa tleleime e tšoanang (ka nako e le 'ngoe), u tla bona mela e mengata e nang le boemo ba tleleime e le 'ngoe.
Ka tlase ke tse file lintlha tsa sebopeho bakeng sa Tlaleho ea Boemo ba EDI.
| Litlaleho tsa Tlhaloso ea Boemo ba EDI | ||
| Lebitso la Tšimo | Qala Pos | Bolelele ba Tshimo |
| File ID | 5 | 9 |
| Klemo ID | 15 | 10 |
| Pat. Molao # | 27 | 14 |
| Mamello | 42 | 20 |
| Chelete | 62 | 9 |
| Mokhoa oa ho sebelisa D | 74 | 10 |
| ID ea Lekhetho | 85 | 10 |
| Molefi | 96 | 5 |
| Mokhoa oa ho lefa Dt | 106 | 10 |
| ID ea Ref | 123 | 15 |
| Boemo | 143 | 8 |
| Molaetsa oa Karabo ea Molefi | 153 | 255 |
SEHLOMATHISO D – TLALEHO EA MAEMO A ERA/835
Office Ally e fana ka mongolo o balehang (.TXT) oa EDI X12 835 file, joalo kaampeo e bontšitsoeng ka tlase:
Tlhahisoleseding e Tloaelehileng ya Pherekano ya Tataiso e Seng e bua ka Ditaelo tsa ho Kenngwa Tshebetsong tse Thehilweng ho X12
Tlhaloso ea 005010X223A2
E ntlafalitsoeng 01/25/2023
Litokomane / Lisebelisoa
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Office Ally OA Processing Application [pdf] Bukana ea Mosebelisi OA Processing Application, OA, Processing Application, Application |
