Date Format

The date format applicable to the login user.

Employee

The unique code and name of the employee who applied for reimbursement from the previous page.

Claim ID

A unique number / ID, to identify all the reimbursement claims that you entered in the “Enter Employee Claim” document.

Reimbursement Item

The reimbursement items applicable to the selected Claim Id will be loaded in the drop-down list box.

From the drop-down list box, select the reimbursement item.

Bill No.

The bill numbers associated with the reimbursement item will be populated in the drop-down list box.

From the drop-down list box, select the bill number.

Bill Date

The date on which the expenses were incurred as specified in the bill.

Bill Amount

The amount specified in the bill submitted for reimbursement.

Sanction Amt/Exception Amt/Authorized Amt

The system displays the sanctioned amount /exception amount/authorized amount.

Visit Date

Enter the date on which the employee consulted the doctor.

Hospitalization Days Authorized

If the Reimbursement item is “Ward Accommodation”, the system displays the number of hospitalization days, which the employee has already reimbursed

Paid By Staff to Institute

The amount, which the staff has to pay to the institute.

Hospitalization Days Pending for Authorization

The number of hospitalization days specified in the reimbursement application that requires authorization.

Recovered From Medisave/Medishield By Institute

The amount that can be recovered from   Medisave/Medishield By Institiute.

Hospitalization Days

The number of days for which the employee/dependant was hospitalized.

Payment To/Recovery From

The values will be populated in the drop-down list box based on the mapping of the reimbursement item to the provider defined in the “Create Provider Details“ activity in the “Reimbursement Setup” component.

From the drop-down list box, select the name of the provider or Self

Paid By

Not applicable

Recover from Third Party

Not applicable

Payment/Recovery

From the drop-down list box, select any one of the following options

“Payment”  indicates that the amount has to be paid to the provider/self.

Recovery indicates that the amount that has to be recovered from the provider/self.

Amount

The amount to be paid or the amount to be recovered

Cheque No./Voucher No.

The cheque number of the cheque or the voucher number of the voucher issued to the provider/self.

Demand Document No,

The Demand Draft number of the DD issued to the provider/self.

Column 1

Any other additional information can be specified in this field.

Column 2

Any other additional information can be specified in this field.

Column 3

Any other additional information can be specified in this field.

Column 4

Any other additional information can be specified in this field.

Column 5

Any other additional information can be specified in this field.

Remarks

Any remarks pertaining to the record of the bill payment

Remarks

Any remarks pertaining to the bill payment details.