Acts Online
GT Shield

Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2019

Dental Services

Umehluko Electronic Invoicing File Layout

 

N188 Electronic Invoicing File Layout

 

UMEHLUKO ELECTRONIC INVOICING FILE LAYOUT

 

Field

Description

Max length

Data type

 

BATCH HEADER



1

Header identifier = 1

1

Numeric

2

Switch internal Medical aid reference number

5

Alpha

3

Transaction type = M

1

Alpha

4

Switch administrator number

3

Numeric

5

Batch number

9

Numeric

6

Batch date (CCYYMMDD)

8

Date

7

Scheme name

40

Alpha

8

Switch internal

1

Numeric

 

DETAIL LINES



1

Transaction identifier = M

1

Alpha

2

Batch sequence number

10

Numeric

3

Switch transaction number

10

Numeric

4

Switch internal

3

Numeric

5

CF Claim number

20

Alpha

6

Employee surname

20

Alpha

7

Employee initials

4

Alpha

8

Employee Names

20

Alpha

9

BHF Practice number

15

Alpha

10

Switch ID

3

Numeric

11

Patient reference number (account number)

10

Alpha

12

Type of service

1

Alpha

13

Service date (CCYYMMDD)

8

Date

14

Quantity / Time in minutes

7

Decimal

15

Service amount

15

Decimal

16

Discount amount

15

Decimal

17

Description

30

Alpha

18

Tariff

10

Alpha

 

 

Field

Description

Max length

Data type

 

19

 

Service fee

 

1

 

Numeric

20

Modifier 1

5

Alpha

21

Modifier 2

5

Alpha

22

Modifier 3

5

Alpha

23

Modifier 4

5

Alpha

24

Invoice Number

10

Alpha

25

Practice name

40

Alpha

26

Referring doctor's BHF practice number

15

Alpha

27

Medicine code (NAPPI CODE)

15

Alpha

28

Doctor practice number  -sReferredTo

30

Numeric

29

Date of birth / ID number

13

Numeric

30

Service Switch transaction number - batch number

20

Alpha

31

Hospital indicator

1

Alpha

32

Authorisation number

21

Alpha

33

Resubmission flag

5

Alpha

34

Diagnostic codes

64

Alpha

35

Treating Doctor BHF practice number

9

Alpha

36

Dosage duration (for medicine)

4

Alpha

37

Tooth numbers


Alpha

38

Gender (M, F)

1

Alpha

39

HPCSA number

15

Alpha

40

Diagnostic code type

1

Alpha

41

Tariff code type

1

Alpha

42

CPT code / CDT code

8

Numeric

43

Free Text

250

Alpha

44

Place of service

2

Numeric

45

Batch number

10

Numeric

46

Switch Medical scheme identifier

5

Alpha

47

Referring Doctor's HPCSA number

15

Alpha

48

Tracking number

15

Alpha

49

Optometry: Reading additions

12

Alpha

50

Optometry: Lens

34

Alpha

51

Optometry: Density of tint

6

Alpha

52

Discipline code

7

Numeric

53

Employer name

40

Alpha

54

Employee number

15

Alpha

 

 

 

Field

 

Description

 

Max length

 

Data type

55

Date of Injury (CCYYMMDD)

8

Date

56

IOD reference number

15

Alpha

57

Single Exit Price (Inclusive of VAT)

15

Numeric

58

Dispensing Fee

15

Numeric

59

Service time

4

Numeric

60




61




62




63




64

Treatment Date from (CCYYMMDD)

8

Date

65

Treatment Time (HHMM)

4

Numeric

66

Treatment Date to (CCYYMMDD)

8

Date

67

Treatment Time (HHMM)

4

Numeric

68

Surgeon BHF Practice Number

15

Alpha

69

Anaesthetist BHF Practice Number

15

Alpha

70

Assistant BHF Practice Number

15

Alpha

71

Hospital Tariff type

1

Alpha

72

Per diem (Y/N)

1

Alpha

73

Length of stay

5

Numeric

74

Free text diagnosis

30

Alpha

 

TRAILER




1

Trailer Identifier = Z

1

Alpha

2

Total number of transactions in batch

10

Numeric

3

Total amount of detail transactions

15

Decimal