SST BPA Integration for Automated Bill Processing

SST – BPA Integration for Automated Bill Processing

Version : 1.0Date: 25-09-2020

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➢ 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.

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Workflow for SST –BPA Bill

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Workflow for SST Bill Processing

Role selected for SST bill creation: SST-DA

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Role selected for SST bill creation: Cash-DA

Workflow for SST Bill Processing

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Workflow Management under User Management Module

Click on Workflow Management

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Select Super Specialty Treatment

BPA Bill from dropdown list

Select Transaction Type

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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.

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Click On Submit

Submit Workflow Request

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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.

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Hospital Master

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Hospital Master Screen

Click on List under

Hospital Master

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Search Hospital by Search Criteria

Click Status as Active

form dropdown List

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Select Hospital Code

Click on Hospital Code

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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.

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Hospital Master Details

Enter Exemption Limit. Select TDS

Exempted From Date & Exempted To Date

from date picker. Then Click on Submit

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

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

Enter User Name and

Password in Text Box

Click on Log IN Button

http://www.myesic.esic.in/

http://www.gateway.esic.in/

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Go to ERP Application → Finance 2.0

Click on Finance 2.0

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Click on Task List

To Submit Super Speciality BPA Bill

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Click on Pending For Bill Submission under

Super Speciality BPA Bill

Super Speciality BPA Bill Pending For Bill Submission

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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

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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

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Select Payment Mode and Account

Type from drop-down List

Enter Payable To

User can scroll to right to view complete bill details


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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

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Super Speciality Treatment Bill

Submitted Successfully

Super Speciality BPA Bill Submitted Successfully

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

Enter User Name and





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Click on Task List

To Verify Super Speciality BPA Bill

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Click on Pending For Approval under


Super Speciality BPA Bill Pending For Approval

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Note: -



Select Bill Number

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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


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Verified Successfully

Super Speciality BPA Bill Verified Successfully

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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List

To Approve Super Speciality BPA Bill

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Note: -



Select Bill Number

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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

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Approved Successfully

Super Speciality BPA Bill Approved Successfully

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

Enter User Name and





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Click on Task List

To Check Super Speciality BPA Bill

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Note: -



Select Bill Number

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Cash DA will enter Notings

then click on Check

Note :-

1. Check – To forward the bill to Cash SO



Check Super Speciality BPA Bill

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Checked Successfully

Super Speciality BPA Bill Checked Successfully

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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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Finance DA can enter

Notings then click on Check

Note :-

1. Check – To forward the bill to Finance SO




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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Check List

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Click on SST – BPA Bill List under

Super Speciality Treatment

To check the record of Super Speciality BPA Bill

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Note: -



Search Bill Number

Click on Get Details to

fetch the results

Enter SID No.

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Select Bill Number

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Check record of Super Speciality BPA Bill

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Click on Print

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Print - Super Speciality BPA Bill

Click on OK

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Print - Super Speciality BPA Bill

Payment Voucher Creation

For Super Speciality BPA Bill

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Enter User Name and





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To Create Payment Voucher by Finance DA

Click on Create New under

Payment Voucher

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Select Bill Type as Super Specialty

Treatment BPA Bill Advance

Select Bill Type

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Select E-Payment as Payment Mode

& Account Type from drop-down list

Select Payment Mode and Account Type

Click on Attach Bills

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Click on check box to select

bill for PV creation

Click on include, to include the

selected bills for PV creation

Include Bills

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Click on Submit after

enter noting

Submit Payment Voucher Request

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Payment Voucher generated successfully

Payment Voucher

generated successfully

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To Generate E- Payment File by Finance DA


E-Payment File Generation

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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

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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

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E-Payment File

Created Successfully

E- Payment File Created Successfully

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Click on List under E-Payment

File Generation

To check parties details under E-Payment

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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

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Click on E-Payment File No

under File.TXT column

Open TXT file for E-Payment File

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User can download or open this TXT

file to check party payment details


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Payment details for Hospital and BPA will generated

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

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

Enter User Name and





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Click on Task List

To Submit Super Speciality BPA Bill

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Click on Pending For Bill Submission under


Super Speciality BPA Bill Pending For Bill Submission

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Note: -



Select Bill Number

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Click on Advance SID Link to

view Advance Bill Details


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Select appropriate Account

Head from drop-down list


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Select Payment Mode and Account

Type from drop-down List

Enter Payable To

User can scroll to right to view complete bill details


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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

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Submitted Successfully

Super Speciality BPA Bill Submitted Successfully

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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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



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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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)




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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Cash DA can enter Notings

then click on Check

Note :-

1. Check – To forward the bill to Cash SO




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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Finance DA can enter

Noting then click on Check

Note :-

1. Check – To forward the bill to Finance SO




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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

Enter User Name and





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Click on Task List


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Note: -



Select Bill Number

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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




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Payment Voucher Creation

For Super Speciality BPA Bill

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Enter User Name and





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Payment Voucher

To Create Payment Voucher by Finance DA

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Select Bill Type as Super Specialty

Treatment BPA Bill Settlement/Final

Select Bill Type

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Select E-Payment as Payment Mode

& Account Type from drop-down list

Select Payment Mode and Account Type

Click on Attach Bills

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Click on include, to include the

selected bills for PV creation

Include Bills

Click on check box to select

bill for PV creation

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Click on Submit after

enter noting

Submit Payment Voucher Request

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Payment Voucher generated successfully

Payment Voucher

generated successfully

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To Generate E- Payment File by Finance DA


E-Payment File Generation

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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

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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

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E-Payment File

Created Successfully

E- Payment File Created Successfully

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Click on List under E-Payment

File Generation

To check parties details under E-Payment

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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

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Click on E-Payment File No

under File.TXT column


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User can download or open this TXT

file to check party payment details


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Payment details for Hospital will generated

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Reports

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Click on Reports under

Reports

Reports

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Click on SST Bill BPA Report

under SST Reports

SST Bill BPA Report

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Select From Date and To Date from

date-picker. Select Transaction Type

from drop-down list.

SST Bill BPA Report

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SST Bill BPA Report

Select Accounting Unit from drop-down list

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SST Bill BPA Report

Select Hospital from drop-down list

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SST Bill BPA Report

Click on View Excel

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SST Bill BPA Report

Click on OK

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SST Bill BPA Report

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Click on SST Bill Summary

Report under SST Reports

SST Bill Summary Report

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Enter Hospital Code. Select workflow

Status from drop-down list.

Note: - User can view report through entering

data in different search fields

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Select Bill Status from

drop-down list

Select Accounting Unit from drop-

down list. Click on View Excel.

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Click on OK

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Notes

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.

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Thank You

SST BPA Integration for Automated Bill Processing

Documents

Transcript of SST BPA Integration for Automated Bill Processing