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Claims → Export EDI
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Claim ID
Internal unique ID.
PatientCode
Internal practice code.
Medical Aid
Select…
PSEM (MetHealth)
PROS (Prosperity)
NHPM
Member No
Dependent Code
Auth No
Patient Surname
Patient First Names
DOB (YYYYMMDD)
Patient ID
Date of Service (YYYYMMDD)
Facility
Start Time (HHMM)
End Time (HHMM)
Notes
Claim lines
Add line
#
Tariff
Description
Qty
Unit Price
Line Total
Mod1
Time
Total
0.00
Exports
Export EDI (Ready)