Switching: Claim Administration

Why Use This Function:

Using an EDI Reversal is important when a submitted claim has been rejected by the Medical Aid due to errors or incorrect information. Instead of creating a new claim from scratch, the reversal allows you to correct and resubmit the original claim accurately. This helps to maintain clean records, avoid duplicate submissions, and ensure quicker resolution and payment from the Medical Aid.

• This user manual will start on the Switch History screen.  
  

• For more information on how to navigate to the Switch History screen, please refer to the user manual: Communication Segment.
  
  
• Select the desired Invoice that you would like to see and view the response of.

• Click on the View Response button to view a detailed response with regards to the specific claim.

• The Switch Details screen will open.

• For more information on the various Switch Responses, please refer to the user manual: WA: Switch Response.
  
  
• Click on the Reverse button to reverse the claim.

💡Please Note: The reversing procedure is automatic, and you will not be informed; therefore, proceed with caution while using the button.

• After Clicking the Reverse button, your claim will be reversed, and the switch status will change. 

💡Please Note: You are now able to make any necessary changes and resubmit the Invoice.