SST BPA Integration for Automated Bill Processing

SST – BPA Integration for Automated Bill Processing

Version : 1.0Date: 25-09-2020

➢ IP/ Employee/ Pensioner can avail Super Specialty Treatment after referral from ESIC to Empanelled Hospital. Empanelled Hospital submits bill for claim to ESIC.

➢ UTI (works as BPA) have tie up with ESIC for scrutinizing bill submitted by empanelled hospital, once bill is submitted by empanelled hospital, UTI will scrutinize the bill, then CFA (Employee of ESIC) will approve bill and pass for payment.

➢ ESIC will make payment to hospital and BPA (Bill Processing Agency) as processing fee for scrutinizing bills. BPA will be paid for every bill they scrutinize either the bill get approved or rejected. In case of Rejected bill, the processing fee will be paid to BPA by ESIC, Processing fee should be deducted from the next bill of the same hospital.

➢ Once settlement ID generated in UTI system, UTI will push the details to ERP with claim details for both CGHS and Non-CGHS package types.

➢ For CGHS bills, the Payment will be processed as Final Payment. For Non-CGHS bills, the payment will be processed in two parts, Advance and Final/ Settlement Payment.

➢ If there is any Recovery Amount, it will be deducted from next bill of Hospital and UTI will send the deducted amount as Recovery Amount in its next bill of the Hospital.

Overview

➢ There will be two types of work flow provided in SST – BPA Bills.

➢ Individual locations can decide on which workflow they need to adapt.

• 1st workflow

• SST Branch → Cash Branch → Finance Branch

• 2nd Workflow

• Cash Branch → Finance Branch

➢ By default SST branch workflow is implemented, locations can change workflow from User Management →

Workflow Management

➢ Locations can change workflow any time based on their convenience, however pending bill will be approved

in old workflow only. New workflow will be applicable for new bills pushed from BPA.

Workflow for SST –BPA Bill

Workflow for SST Bill Processing

Role selected for SST bill creation: SST-DA

Role selected for SST bill creation: Cash-DA

Workflow for SST Bill Processing

Workflow Management under User Management Module

Click on Workflow Management

Select Super Specialty Treatment

BPA Bill from dropdown list

Select Transaction Type

Select any of workflow option

from dropdown list

Select Workflow Option

Note: -

1. User will select the workflow as per location convenience.

2. Default workflow will be SST Branch > Cash Branch > Finance Branch.

3. Changed workflow will be applicable for next coming bills from UTI.

Click On Submit

Submit Workflow Request

Workflow Request Submitted Successfully

➢ New Fields are added in Hospital Master.

• Contact Person, Contact Number, Pending Recovery Amount (Based on Recovery from hospital, it is auto

calculated field), TDS Exemption (Yes/ No) and Exemption Limit

• Removed MICR Code from Bank Details

➢ TDS will be exempted for bill if it is created in exemption period and within limit threshold for SST Bill

and SST – BPA Bill

➢ If Exemption limit is crossed in financial year then TDS exemption will not be given, system will show

popup as ‘Exemption limit crossed’.

➢ This validation will be reset as per Financial Year Cycle.

Hospital Master

Hospital Master Screen

Click on List under

Hospital Master

Search Hospital by Search Criteria

Click Status as Active

form dropdown List

Select Hospital Code

Click on Hospital Code

Hospital Master Details

Pending Recovery Amount for Hospital will

reflect, it will be auto calculated

TDS Exemption if applicable

Select Yes otherwise select No

Note: -

User can edit any of hospital details if required.

Hospital Master Details

Enter Exemption Limit. Select TDS

Exempted From Date & Exempted To Date

from date picker. Then Click on Submit

SST BPA Bill Submission & Approval Process for Non CGHS Bill for Payment Type as Advance

SST DA Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Password in Text Box

Click on Log IN Button

Go to ERP Application → Finance 2.0

Click on Finance 2.0

Click on Task List

To Submit Super Speciality BPA Bill

Click on Pending For Bill Submission under

Super Speciality BPA Bill

Super Speciality BPA Bill Pending For Bill Submission

Click on Bill Number

Note: -

1. Get Details – To fetch the record from selection criteria

2. User can search the Request through search criteria

Select Bill Number

Note: -

1. In one SID, only bills for one type of beneficiary will reflect.

2. For CGHS bills, the Payment will be done at once as Payment Type received from UTI as Final. For Non-CGHS bills, the payment will be

done in two parts, first is Advance and then Final Payment.

3. In Party Details, hospital’s exempted limit, exempted period, contract period and bank account details will reflect.

4. If any recovery amount is pending on hospital, same will reflect under Previous Recovery Amount.

5. If hospital exemption threshold has crossed or exemption period is over then system will ask to select TDS percent mandatorily.

Submit Super Speciality BPA Bill

Select Payment Mode and Account

Type from drop-down List

Enter Payable To

User can scroll to right to view complete bill details

Select appropriate TDS from drop-down list

Click on Submit, after entering notings

Note:-

1. Reset – To clear the filled data in the bill

2. Submit – To submit the bill

3. Back – To move back to List Page

Super Speciality Treatment Bill

Submitted Successfully

Super Speciality BPA Bill Submitted Successfully

SST SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

To Verify Super Speciality BPA Bill

Click on Pending For Approval under

Super Speciality BPA Bill Pending For Approval

Note: -

Select Bill Number

Verify Super Speciality BPA Bill

SST SO can change the TDS details form drop-down list

SST SO will Enter Notings then

click on Verify/ Send Back

Note :-

1. Verify – To forward the bill to DMS (only if location is

hospital) or SMC (other than hospital location)

2. Send Back – To send the bill back to SST DA

3. Print – To print the bill

Verified Successfully

Super Speciality BPA Bill Verified Successfully

DMS Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

DMS can Enter Notings then

Note :-

1. Verify – To forward the bill to SMC

2. Send Back – To send the bill back to SST SO

SMC Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

To Approve Super Speciality BPA Bill

Note: -

Select Bill Number

SMC/ SMO enters Noting then

click on Approve/ Send Back

Note :-

1. Approve – To forward the bill to Cash DA

2. Send Back – To send the bill back to DMS (Hospital

location) or SST SO (Other than hospital location)

Approve Super Speciality BPA Bill

Approved Successfully

Super Speciality BPA Bill Approved Successfully

Cash DA Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

To Check Super Speciality BPA Bill

Note: -

Select Bill Number

Cash DA will enter Notings

then click on Check

Note :-

1. Check – To forward the bill to Cash SO

Check Super Speciality BPA Bill

Checked Successfully

Super Speciality BPA Bill Checked Successfully

Cash SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Cash SO will enter Notings then

Note :-

1. Verify – To forward the bill to DDO

2. Send Back – To send the bill back to Cash DA

DDO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

DDO can enter Notings then click

on Approve/ Send Back/ Return

Note :-

1. Approve – To forward the bill to Finance DA

2. Return – To Send back the bill to SMC

3. Send Back – To send the request back to Cash SO

Finance DA Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance DA can enter

Notings then click on Check

Note :-

1. Check – To forward the bill to Finance SO

Finance SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance SO can enter Notings

then click on Verify/ Send Back

Note :-

1. Verify – To forward the bill to Finance HOB

2. Send Back – To send the bill back to Finance DA

Finance HOB Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance HOB can enter Notings then click on

Approve/ Send Back/ Return

Note :-

1. Approve – To approve the bill for PV Creation

2. Return – To send back the bill to SMC/ SMO

3. Send Back – To send the bill back to Finance SO

Check List

Click on SST – BPA Bill List under

Super Speciality Treatment

To check the record of Super Speciality BPA Bill

Note: -

Search Bill Number

Click on Get Details to

fetch the results

Enter SID No.

Select Bill Number

Check record of Super Speciality BPA Bill

Click on Print

Print - Super Speciality BPA Bill

Click on OK

Print - Super Speciality BPA Bill

Payment Voucher Creation

For Super Speciality BPA Bill

Enter User Name and

To Create Payment Voucher by Finance DA

Click on Create New under

Payment Voucher

Select Bill Type as Super Specialty

Treatment BPA Bill Advance

Select Bill Type

Select E-Payment as Payment Mode

& Account Type from drop-down list

Select Payment Mode and Account Type

Click on Attach Bills

Click on check box to select

bill for PV creation

Click on include, to include the

selected bills for PV creation

Include Bills

Click on Submit after

enter noting

Submit Payment Voucher Request

Payment Voucher generated successfully

Payment Voucher

generated successfully

To Generate E- Payment File by Finance DA

E-Payment File Generation

Search Payment Voucher for E-Payment

Note :-

User will select From Date and To Date to search payment voucher created in

that duration. Then click on Search, Payment Voucher Details will fetch.

Click on Search

Create E-Payment

Click on Create File

Click on check box to include PV for E Payment

Note :-

1. Select Payment Vouchers for E-Payment by click on check box

2. Enter Debit Date and Noting

E-Payment File

Created Successfully

E- Payment File Created Successfully

Click on List under E-Payment

File Generation

To check parties details under E-Payment

Search E- Payment File

Click on Get Details after

entering dates in search filters

Note: - User can search E-Payment File through

entering data in different search fields

Click on E-Payment File No

under File.TXT column

Open TXT file for E-Payment File

User can download or open this TXT

file to check party payment details

Payment details for Hospital and BPA will generated

Super Speciality BPA Bill Submission & Approval Process for Non CGHS Package for Payment Type as Final

SST DA Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

To Submit Super Speciality BPA Bill

Click on Pending For Bill Submission under

Super Speciality BPA Bill Pending For Bill Submission

Note: -

Select Bill Number

Click on Advance SID Link to

view Advance Bill Details

Select appropriate Account

Head from drop-down list

Select Payment Mode and Account

Type from drop-down List

Enter Payable To

User can scroll to right to view complete bill details

Select appropriate TDS from drop-down list

Click on Submit, after enter noting

Note:-

1. Reset – To clear the filled data in the bill

2. Submit – To submit the bill

Advance Paid Amount for claim ID

Submitted Successfully

Super Speciality BPA Bill Submitted Successfully

SST SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

SST SO can enter Notings then

Note :-

1. Verify – To forward the bill to DMS (only if location is

hospital) or SMC (other than hospital location)

2. Send Back – To send the bill back to SST DA

DMS Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

DMS can enter Notings then

Note :-

1. Verify – To forward the bill to SMC

2. Send Back – To send the bill back to SST SO

SMC Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

SMC/ SMO can enter Notings

then click on Approve/ Send Back

Note :-

1. Approve – To forward the bill to Cash DA

2. Send Back – To send the bill back to DMS (Hospital

location) or SST SO (Other than hospital location)

Cash DA Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Cash DA can enter Notings

then click on Check

Note :-

1. Check – To forward the bill to Cash SO

Cash SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Cash SO can enter Notings

Note :-

1. Verify – To forward the bill to DDO

2. Send Back – To send the bill back to Cash DA

DDO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

DDO can enter Notings then click on

Approve/ Send Back/ Return

Note :-

1. Approve – To forward the bill to Finance DA

2. Return – To Send back the bill to SMC

3. Send Back – To send the request back to Cash SO

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance DA can enter

Noting then click on Check

Note :-

1. Check – To forward the bill to Finance SO

Finance SO Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance SO can enter Notings

Note :-

1. Verify – To forward the bill to Finance HOB

2. Send Back – To send the bill back to Finance DA

Finance HOB Login through myesic.esic.in or gateway.esic.in

Enter User Name and

Click on Task List

Note: -

Select Bill Number

Finance HOB can enter Notings then

click on Approve/ Send Back/ Return

Note :-

1. Approve – To approve the bill for PV Creation

2. Return – To send back the bill to SMC/ SMO

3. Send Back – To send the bill back to Finance SO

Payment Voucher Creation

For Super Speciality BPA Bill

Enter User Name and

Payment Voucher

To Create Payment Voucher by Finance DA

Select Bill Type as Super Specialty

Treatment BPA Bill Settlement/Final

Select Bill Type

Select E-Payment as Payment Mode

& Account Type from drop-down list

Select Payment Mode and Account Type

Click on Attach Bills

Click on include, to include the

selected bills for PV creation

Include Bills

Click on check box to select

bill for PV creation

Click on Submit after

enter noting

Submit Payment Voucher Request

Payment Voucher generated successfully

Payment Voucher

generated successfully

To Generate E- Payment File by Finance DA

E-Payment File Generation

Search Payment Voucher for E-Payment

Note :-

User will select From Date and To Date to search payment voucher created in

that duration. Then click on Search, Payment Voucher Details will fetch.

Click on Search

Create E-Payment

Click on Create File

Click on check box to include PV for E Payment

Note :-

1. Select Payment Vouchers for E-Payment by click on check box

2. Enter Debit Date and Noting

E-Payment File

Created Successfully

E- Payment File Created Successfully

Click on List under E-Payment

File Generation

To check parties details under E-Payment

Search E- Payment File

Click on Get Details after

entering dates in search filters

Note: - User can search E-Payment File through

entering data in different search fields

Click on E-Payment File No

under File.TXT column

User can download or open this TXT

file to check party payment details

Payment details for Hospital will generated

Reports

Click on Reports under

Reports

Click on SST Bill BPA Report

under SST Reports

SST Bill BPA Report

Select From Date and To Date from

date-picker. Select Transaction Type

from drop-down list.

SST Bill BPA Report

Select Accounting Unit from drop-down list

SST Bill BPA Report

Select Hospital from drop-down list

SST Bill BPA Report

Click on View Excel

SST Bill BPA Report

Click on OK

SST Bill BPA Report

Click on SST Bill Summary

Report under SST Reports

SST Bill Summary Report

Enter Hospital Code. Select workflow

Status from drop-down list.

Note: - User can view report through entering

data in different search fields

Select Bill Status from

drop-down list

Select Accounting Unit from drop-

down list. Click on View Excel.

Click on OK

1) List : All view past and present records are available under List option for the transaction based on

search criteria

2) Task List : All the pending request will be available for the logged in user under Task List for all

transactions.

3) Audit Trail (Noting History): Application shows the workflow for any request with defined noting's

under Noting History

4) Search option : Wide range of filtering criteria are provided under List Option to search any

transaction.

Thank You

SST BPA Integration for Automated Bill Processing

Documents

Transcript of SST BPA Integration for Automated Bill Processing

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