Enhanced EDT File Processing

Date of Tech Note: 28 July 1999
Enhancement: 28 July 1999
Bug Fix: N/A

Description

When sending files to OHIP via EDT, they send back numerous files, particularly if you send in a billing file for each doctor in your clinic. If you have 40 physicians in your clinic and you send a billing file in every day you would have the following files returned to you every day:

• Response.txt (OBEC file)
• A file acceptance/rejection file for each file rejected (if there were any)
• A batch acceptance/rejection for each batch sent in

This could amount to 50 files everyday.

When you receive your Remitance files back, this would be another 40 files on those days.

To make the processing of these files easier, MediFile will now process these files all at once if they are in a folder all by themselves.

Detail

When you download the files to your local computer, you would download them to the same folder. They should be in a folder all to themselves.

From Page 1 of the Administration Corner, select Process EDT Results:

You will be asked to select the folder that the result files are contained in. These could include the following file-types:

• File rejections
• Batch acceptance/rejections
• Claims exception reports

Once you select the folder, MediFile will process all the files in the folder. It will only process the files that match the type indicated. If a file does not correctly match the type, MediFile will create a line in the problem report with the file name, and will leave the file alone.

As MediFile is processing the files, it will provide you with an idea of how far along in the process it is.

In the case shown here, there are 3 files to process and it is on the second file. It is currently processing a Claims Error report. It is on line #62 of this file.

As MediFile finishes processing each file, it creates a report in the Alert file, which contains the result that was sent. Of course, it is processed to be much more readable than it is in the OHIP file.

As each file is processed, a record is created in the statement file as well. MediFile does this so that it can check to see if it has processed the file previously and, if it has, it will create a line with the file information in the problem report.

Once all the files have been processed, you will be presented with a summary report. For example:

In this case, MediFile is indicating that all Batches were accepted, and none refused. Eleven batches were processed and accepted.

Two error files were processed. MediFile gives you the name of the file, the number of claims rejected and the total dollar value within the file. MediFile will have maked each billing with a status of Refused with the refusal reason in the Code Out area.

MediFile won’t let you process a File

This will happen if MediFile sees that you have previously processed the file. To check this out, you must go to the 1st page of the Administration corner. In the Payment / Billing popup, select Statements. In this file, MediFile will have written each file that it has ever processed from EDT.

MediFile will provide you with the File name, process date, area account, and the rejected dollar value in the output layout. If you double click on it, it will give you more information about that file.

The details of the processed files will be stored in the Alert file.

An example of the details from the EDTClaims file is shown here.

Details from a batch file are shown here.

In most cases, you will not print out any of these reports. Should you wish to, though, they are available from the Alert File.