Page 22 - C.Journal 4th edition
P. 22

Claims Journal 4th Edition                                                                                                                                                          Claims Journal 4th Edition


            Technical Corner                                                                                                       If Statement was completed


                                                                                                                                   1. Showing provider name
             Prompt Payment Process                                                                                                2. Period
                                                                                                                                   3. Company name

                                                                                                                                   4. All calculations are correct.
             Prepared by Suha Almenee

                                                                                                                                   If Statement have issue
                                                                                                                                   1. Not Showing provider name
                                                                                                                                   2. Wrong Period
                                                                                                                                   3. Not showing Company name
                                                                                                                                   4. Calculations mistake
                                                                                                                                   5. Statement not matching with covering letter



                                                                                                                                   We hold the payment due to :
                                                                                                                                   - If the statement have issue, update CM under category (Non-compliance general
                                                                                                                                   summary statement)  with kind of issue and the payment will be hold until the issue
                                                                                                                                   solved.
                                                                                                                                   - If the statement showing high or low amount compered to previous amounts, in-
             Physical Batches:                                                                                                     form the PR and wait their confirmation

             1) Mailing  Room : Receive batches from shippers and record                                                           - Fraud cases or Hold as per relation
             2) Claims: Forward to CCU.
             3) Statement : with receive from forward to payment team.                                                             Prompt Payment


             Create a Batches:
             To create the batches we use Caesar , Microsoft Excel.
             In Caesar

             Fill the figures based on the Statement
             1. Showing complete figures ( Gross, Discount, Deductible and Net)
             2. If the Statement only showing Net amount,  for Discount and Deductible we put
             0 and the net will be the present amount
             Then will amended by recon after reconcile the batch .
             In Excel
             Help to make sure the statement  calculation and showing all providers note :
             * Hold
             * Deduction
             * Payment agreement
             * Claims type








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