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Send electronic billing of services to insurances

Explanation​

Invoices for insurances can be generated in an electronical format, actually a XML based upon the standard of the Swiss Health Care System www.forum-datenaustausch.ch. It needs an official transporter like Swisscom HealthCare or MediData.

Setup​

To ensure a correct XML-formatting, some mandatory values must be set:

institution​

  • GLN : enter the GLN of the institution
  • Link the institution to the correct transporter connection. If not defined, it take the one in the setup.

HC Service​

  • Rate Cipher : select the correct cipher value
  • Tariff code : will be filled out automatically (from cipher setup)

Customer (insurances)​

  • GLN : enter the GLN of the participant (insurance)
  • GLN Receiver : enter the GLN for the Receiver (specific insurance destination)
  • Electronic Format : chose the desired format version
  • Use GLN in Electronic documents: flag to TRUE
  • Territory code : enter the canton where the insurance resides

Beneficiary Contact card​

  • Territory code : enter the canton where the beneficiary should be invoiced

medical doctor Contact card​

or on the Addressbook

For Medical Doctor only:

  • Referrer GLN : enter the GLN of the Medical Doctor (needed in the XML file)
  • Referrer VCR : enter the VCR of the Medical Doctor (needed in the XML file)

optional​

Customer card (beneficiaries)

  • In addressbook, specify the Police No for the main insurance

Customer card (insurances)

  • Disable Electronic Invoice Rounding: this won't generate the rounding line 970 at the end of the XML file. You'll have rounding difference between balance amount and total amount of the detail lines.
  • Invert. Electr. Cred. Memo Balance: this will write negative sign on the balance amount in the XML file.
tip

The payment method code must be configured on the customer. It must have a bank selected to have a complete bank address with post code and city. The bank information available in the Company Information is not precise enough.

Send invoices​

All invoices in the defined period for customers with a non-empty Electronic Format field will be sent. Everything about the sending of electronic invoices happens in one single journal page, use Tell Me and enter XML Invoice Journal, or on the main menu, under Interface | Export | Electronic Invoice. You can start the process manually using the Action menu and Generate All Documents. On the request page, specify the period to consider, add some filters like institution or customer filter. Don't forget to activate the Test mode if requested. The correct sequence is described in the following synoptic.

note

To determine wether an invoice will be printed or not, several parameters are relevant. On the Institution the VCR code and its flag Electronic Payment enabled. On the customer of the invoice: when the customer if flagged Electronic payment enabled, the system will ask for a print confirmation. When printing using MassPrinting, you can define before printing, whether to get all electronic documents on paper or none.

caution

The XML Version 4.5 of [forum-datenaustausch.ch] does not support credit memo documents. Therefore, it is mandatory to reverse the entire invoice (marked as reversed) and re-invoice all services with a new invoice. Business Central and E-Care have been adapted so that invoice corrections cannot be partially reversed, but a correction always results in a applied credit memo for the entire invoice. As of now, it appears that with the upcoming version 5.0, it should be possible to manage credit memo documents.

Learn more about it​

to learn more about it, and especially about the XML-file structure, see here.

Process synoptic​

The status​

Transporter Status can be:

  • To send : Document XML-files generated, waiting for dispatch
  • Sent : Document sent
  • Processing: Document transfered from transporter to insurance
  • Ok : Insurance confirm reception
  • Error : Transporter cannot send document
  • To Print : document won't be dispatched, please print it and use paper mail.

Answer Status can be:

  • Pending : insurance awaiting further information before validation
  • Accepted: insurance accepted the invoice->should be paid
  • Rejected: insurance rejected the document, read the answer for more details
  • Frozen: (not used today)
  • (empty)

Line Status can be:

  • Confirmed: (not used today)
  • Resent: the document has be resent, this line is the old one
  • Closed: the document in error has been processed by you, this line can be closed
  • (empty)

Possible Actions are:

  1. Generate all documents
  2. Send All Documents
  3. Get Status
  4. Get Answers
  5. Re-Generate
  6. Close

For 1-2-3-5-6, it will execute the action for one or some selected lines only. The Get Answers (4) will always request answers for all those whose answers are empty. Once an answer is read, the transporter (MediData, Swisscom HNet...) will automatically receive the Answer Confirmation so it will archive the document in their system.

tip

Scheduler or Job Queue should be setuped in order to have the Get Status/Get Answers automatically triggered in background.

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