smeMetrics

Practice Management Software

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How to create a quote on smeMetrics

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In this article we will guide you on how to create a quote on smeMetrics. Quotes can be used to indicate how much sessions would cost a parent or if you need to motivate for funding from a medical aid scheme.

Settings

In order to generate a quote you do need to update your system settings. To do this go to settings/my invoice info. You will then need to make sure that the option for “Exclude Future (Consolidated) Invoice” is not ticked. You will also need to tick the option “Enable Pro-Forma Invoices” then click save.

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Creating your Quote.

Now that your settings are correct, you are ready to make a quote. Go to Billing/ Invoices and click on the new button.

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Once you have done that you will enter the name of the patient that you are doing the quote for .

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Note:: If it’s a new patient you will first need to create the contact for that patient.

Add in the line items that you will be billing for, if you are using invoice templates you can pull them in using the dropdown on the right of the screen.

Make sure to future date the invoice so that it becomes a quote

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Note :: Remember that the first line does not have an ICD-10 code you can manually add the code or simply remove the line.

Once you have created your invoice/quote click the save button. Now click on View and you will see that the new invoice has ben created and states Quote at the top. You can then download the quote and email it to the relevant person.

Adding Labels to Clients and Invoices

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We recently released a new feature that allows you add a label to a contact as well as an individual invoice. This feature will allow you to quickly see the type of client, clients’s referral source or reason for non-payment on an invoice.

Enabling Labels

In order to activate labels you need to go to settings/ My Label Info and tick the show labels option. When you add a new label you cannot have spaces between the words so you need to use a dash or an underscore ( eg: PMB-Client, MSA_Depleted)

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Here you will be able to activate the labels as well as add new labels and colour code them to your specifications.

Contact Labels

You can add labels to a contact when you capture their information or as you go, by simply clicking on the +label button once you have selected a contact.

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As you can see you can now at a glance see the type of client when you open your contacts page.

Invoice Labels

This is a powerful tool and helps when you are following up on accounts or need to keep track of how many PMB sessions a client has used ect.

At a glance you can see why an account was not paid or if it came from the clients PMB sessions.

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Adding a label to an invoice is a quick as selecting the invoice and clicking on the + label button. This feature will allow you to see all labels on a clients invoices which helps when you are following up on overdue accounts.

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Loading EDI Credits on smeMetrics

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One of the most important things in your practice is billing or invoicing timeously to ensure that your claims reach the medical aid in time for the next payment run. The easiest way to do this would be to submit your claims via EDI (Electronic Data Interchange). 

Submitting claims through EDI means the claim goes directly into the scheme’s claims processing pool and does not still need to be manually processed by an agent at the scheme. These claims therefore hit the scheme immediately and are processed faster, resulting in a better cash flow for the practice. EG: A claim sent via EDI on a Saturday afternoon will be process for payment on the following weeks payment run, but a claim sent via email on the same day will only be processed for payment the week thereafter. 

Loading Prepaid Credits for your EDI submissions on smeMetrics

EDI claims on smeMetrics, work on a prepaid basis, so that you can track your usage and see what you have spent your credits on. To load credits you please follow the links below

Prepaid Credits (ZAR, R100) – 

Prepaid Credits (ZAR, R200) –

Prepaid Credits (ZAR, R500) – 

Once you have made payment please send the proof of payment to support@smemetrics.com in order for the accounts team to load the funds. 

If there are multiple practitioners on your account you will need to indicate in your email, which practitioner the funds need to be allocated to or how you would like the funds split between practitioners :: EG :: Split funds evenly between practitioners A, B and C or load R 200.00 to A, R 350 to B and R 100 to C

How to check your EDI Balance and usage on smeMetrics

Once you have loaded the credits you will receive a paid invoice for your records from smeMetrics, to check if the credits have been loaded, go to settings/ Mu Subscription info and you will be able to see your Pre-Paid balance. 

You can also set an minimum balance threshold and notification so that the system will send you an email when you reach the threshold, giving you time to reload funds before you run out of credits. My recommendation is to set this threshold for R 100.00 that will allow at least 20 to 25 claims before you run out of credits. 

To check what your credits have been used on click on the little speech bubble next to the balance amount. 

This will bring up the below pop up screen where you can see all transactions. 

Need Further Help from Our Team

You can either send an email with the description of your query to support@smemetrics.com, or you can book a training session with our team at https://www.smemetrics.com/demo/

Medical Aid Claims via EDI :: Sending Claims using EDI ( Switching)

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One of the most important things in your practice is billing or invoicing timeously to ensure that your claims reach the medical aid in time for the next payment run. The easiest way to do this would be to submit your claims via EDI (Electronic Data Interchange). 

Submitting claims through EDI means the claim goes directly into the scheme’s claims processing pool and does not still need to be manually processed by an agent at the scheme. These claims therefore hit the scheme immediately and are processed faster, resulting in a better cash flow for the practice. EG: A claim sent via EDI on a Saturday afternoon will be process for payment on the following weeks payment run, but a claim sent via email on the same day will only be processed for payment the week thereafter. 

How to switch to EDI on smeMetrics

To make the switch from email to EDI submissions you need to go to settings/ My Business info and scroll down to the section called “My Medical Aid Claim Preference”. You need to change the settings from Email to EDI.

Once you have made the change click the save button, you will be logged out of the system in order for smeMetrics to make the change on the back end, simply log back in and you will now be able to sent claims via EDI 

Claiming using EDI submissions

The important thing to remember when using EDI is that you need to make sure that you have the below information and that it is accurate otherwise your claim wont be submitted or will be outright rejected 

  1. Patient’s Name 
  2. Patient’s Date of Birth
  3. Dependent code for the main/principle member
  4. Dependent code for the patient. 


To invoice claims using EDI you will follow the same steps as your regular invoicing Click here for info the only difference is that in your billing/invoices section you will now have a button that says “submit” instead of “mail” an additional button called “Claim History” and an additional column called “Claimed Date” 

To check if your claim has been submitted successfully, click on claim history and the below screen will open up. 

If you click on “Claim response you will get a more detailed response advising if the claim has been accepted, rejected etc 

Full Acceptance :: Means that the scheme has accepted the claim but does not guarantee payment

Partial Acceptance :: Means that the scheme has accepted the claim but that it will be manually processed and does not guarantee payment. 
Rejected :: Means the claim has been rejected. 

Some scheme’s will give a more detailed message such as the example above. 

If a claim is rejected due to ICD-10 code, BHF code, Date of Birth ect the system will advise of the rejection reason and you can amend the claim and resubmit. 

Need Further Help from Our Team

You can either send an email with the description of your query to support@smemetrics.com, or you can book a training session with our team at https://www.smemetrics.com/demo/

Adding a User to smeMetrics Account

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smeMetrics allows you to have unlimited users on your account. The users could be your admin person, bookkeeper, debtors clerk etc. In this article we will show you how to add a new users as well what each of the user roles allows the user to do.

Adding a user.

To add a new user go to settings and scroll down to users. This will open the users page. Click on new and follow the below steps.

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  • Create a unique username.
  • Add the users first and last name as well as email address.
  • Select the user role.
  • Create a strong password.

Once you have created the user , you can send the login information to them.

User Roles.

Admin ::
This is the administrator rights on the system. A user with this role can access the system settings and make changes to the settings. This user can also add new contacts, appointments, generate invoices, allocate payments etc. They have full access to everything.

Support ::
This user has limited access to the system. They can see the dashboard, activities, contacts and calendar. They can add new contacts, schedule appointments ect, but cannot invoice or allocate payments. This user type can also add notes but can only see the notes that they added to the system. The only setting they have access to is their own user information.

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Billing ::
This user has more rights than a support user and can access billing. They can add contacts, schedule appointments, generate invoices and allocate payments. This user can also add notes but can only see the notes that they added to the system. Users with billing rights can also access certain settings which will allow them to update invoice, mail, calendar and business settings.

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Supervisor ::
Users with this role type would normally be a locum or temporary staff member. This user type has the same functionality as a user with the support role, the only exception is that they can add notes and read notes that have been created by another user. This is so that if you bring in a locum they can see the patient notes on patients that they treat.

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Medical Aid Claims via EDI :: Member Benefit Check and Claim Reversals

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A medical aid claim submission via EDI offers one the ability to get a faster response on the claim receipt with each medical aid, and also the potential to get paid faster (since the claim is processed quicker and can make it’s way into the payment batches faster). Another two major benefits of EDI claim submissions rather than email based claim submissions is the ability to do a claim benefit check (ie. will the medical aid claim be accepted by the medical aid) and can you reverse the claim if there is a mistake. In terms of the latter benefit, the only way to reverse a claim on an email based claim or after the claim is outside the claim reversal window, is to phone the call-centre of the medical aid and get them to reverse this for you.

Three notes on this functionality:
1. The claim benefit check is only available for Discovery and GEMS medical aid schemes.
2. The ability to reverse an EDI submitted claim is only available in the day that the claim was submitted.
3. There is a cost for each claim benefit check, and for each claim reversal.

Claim Benefit Check

This functionality is available when you generate your invoice and click the Submit button.

Claim Reversal

This functionality is available when you have submitted your claim to the medical aid via EDI and then click on the Claim History button.

Need Further Help from Our Team

You can either send an email with the description of your query to support@smemetrics.com, or you can book a training session with our team at https://www.smemetrics.com/demo/