Payment tracking and settlement reconciliation¶

Once your lump sums have been sent via eFact, the real question remains: “have I been paid?”. This page explains how Resthome answers it, from the automatically reconciled settlement (920900) to chasing overdue insurers (OA).

You’ll find everything in the MR/MRS → eHealth → eFact app:

• the Cockpit — your “what to do now” control board;

• eFact Settlements — the list of settlements received;

• eFact Batches — each batch and its Payment tab.

Acknowledgement (931000) or settlement (920900): how to tell them apart¶

1. The settlement (920900) reconciled automatically¶

When a settlement comes back from the OA (via automatic retrieval or a batch’s Process Response button), Resthome reconciles it on its own, with no input from you:

1. it creates a Settlement record attached to the batch;

2. it re-links each line of the settlement to the billed line of the right resident (by NISS and amount);

3. it marks each line accepted or rejected; an accepted lump sum is not repeated in the settlement, so any line not mentioned is deemed accepted (AViQ rule);

4. it updates the batch status: settled (all accepted), rejected (all rejected) or partial_reject (a mix, or a partial settlement awaiting the rest);

5. if lines are rejected, it automatically prepares a remainder to resubmit them (see eFact rejections).

Under Account C, as soon as the settlement carries a real payment reference and a positive accepted amount, the batch is marked Paid automatically. A fully rejected settlement (€0 accepted) carries a reference but pays nothing — so it is not marked paid.

2. The eFact Settlements screen (the settlements)¶

Menu eHealth → eFact → eFact Settlements. This is the list of all settlements (920900) received, one per payment.

The list shows: the reference, the batch concerned, the receipt date, the Accepted / Rejected / Paid amounts and the payment reference, plus a status badge.

Open a settlement for the details. The screen is read-only (nothing is entered by hand) and follows three states:

• The Process button appears only if a settlement has stayed in Received without processing — click it to allocate the lines.

• The Mark Reconciled button confirms receipt of the payment once verified on your bank statement.

The Lines tab details, line by line: no., resident, amount claimed, accepted, rejected, the Accepted checkbox, and — in case of refusal — the code and rejection reason. Rejected lines stand out in red.

3. A batch’s Payment tab¶

On a batch (eFact batches), once the batch has been sent, the Payment group summarizes the payment status:

• Paid — the checkbox turns green when the batch is paid;

• Payment Reference — the OA’s payment reference;

• Payment Date — the date (often empty under Account C, see above);

• Total Paid — the amount paid.

A Status box shows in a badge what the batch is waiting for: Awaiting OA response, Awaiting settlement (920900), Complete or Rejected. When a batch is settled, the Close button lets you file it away for good.

In the batch list, the Paid / Unpaid filters and the optional Payment Ref., Payment Date, Amount Paid columns help you take stock month by month.

4. The eFact Cockpit: “have I been paid?” at a glance¶

Menu eHealth → eFact → Cockpit (also accessible from a period or a dashboard card). The Cockpit organizes all the work into action stacks, with a counter and a button per stack. Three stacks answer the payment question directly.

• To reconcile — the batches settled but whose payment is not yet confirmed. The total expected amount is shown; the Reconcile payments button opens the list to reconcile them one by one.

• Overdue payments — the batches accepted but still unpaid whose OA payment deadline has passed. See chasing below.

• Rejected lines — the worklist of rejected lines still to be resent (resident + code + amount), filterable by cause, OA and month.

Two markers round out the picture:

• OA retrievals — the complete log of everything the OA has returned: acknowledgements, settlements and rejections, filterable by OA, month and type, with an Export XLSX button.

• Rejects by cause — a table that groups the rejected lines by reason, to tackle the systemic cause rather than line by line.

5. Chasing an overdue OA¶

The Overdue payments stack lists the batches submitted on time, accepted by the OA but unpaid beyond the deadline. The Chase (by OA) button opens these batches grouped by insurer: you immediately see who to chase and for how much (the accepted total is summed per OA).

To write to the OA, the Contact OA button (present on each batch) prepares contact with the right billing correspondent.

6. Late-payment interest (moratory interest)¶

A batch paid too late may entitle you to late-payment interest. Resthome applies the AViQ rule:

• the batch must have been submitted on time (sent by the 20th of month M+1 at the latest) — this is the eligibility condition;

• the OA must pay by the end of the 2nd month following submission: this is the OA Payment Deadline;

• past this date, interest accrues, calculated as: accepted amount × annual legal rate × days late / 365.

On the batch, as soon as the deadline has passed and the batch is still unpaid, a Late-payment interest (OA) group appears with the deadline, the days late and the interest due. The batch list offers the OA Payment Overdue filter and an OA Pay Deadline column (in red if passed).

Key points to remember¶

• The acknowledgement (931000) pays nothing; only the settlement (920900) tells you what is actually paid.

• Resthome reconciles the settlement automatically: lines allocated, batch status updated, remainder created for the rejections.

• Under Account C, a settlement with a real payment reference marks the batch Paid automatically (the payment date may stay empty).

• Reconciling a settlement (Mark Reconciled) means confirming the money received; the Cockpit gathers the To reconcile and the OAs to chase.

• Late-payment interest is only calculated after entering the legal rate in the eHealth settings.

Further reading¶

• Electronic billing (eFact)

• eFact rejections — causes and solutions

• Billing a month

• eHealth settings

• eHealth overview