Extended Sickness Benefits ESI

Extended Sickness
Benefit
Version 3.2
Last Revised on : 01-07-2018

Agenda
1. Overview
2. Upload certificate
3. Claim Creation
4. Claim Processing
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Overview

Workflow for ESB
DA / LDC / UDC System displays the DA / LDC / UDC will

Insured Person
enters Insurance IP details and upload Certificates
walks in no. in application if required
Contribution details
Claim Submitted to DA / LDC / UDC will DA / LDC /UDC will

BM Refers to MR
BM process a Claim create a claim
MR approves Med8 BM will process a

BM approves Rate
& Rate card sent to claim by Attaching BM Approves claim
card
BM Rate card

Note
• WE have already created the claim for the IP no 1125133150 for 90 days sickness benefit, it will take
70% of daily wage as sickness benefit and after that it will calculate 80% of daily wages for remaining
days.
• For Creating ESB we need to upload the Med8 certificate first.

Upload Certificate

Login Page
Enter User name

and Password
Click on Login

Application Home Page
Scroll the mouse curser over

the application and choose
the Insurance from drop
down menu

Select user
location from drop
down menu

Login as LDC/UDC at Branch Office
Select the role as

LDC/UDC at branch
office

Click on
Submit

Upload Certificate
What are the Certificates to be uploaded for SB?
– IMO / IMP Certificate

Medical Certificate (Regulation 57,58,59)
– Alternate Certificate
Private or Government Hospital Certificate

LDC/UDC will upload certificate
Click on Upload
certificate

Uploading Med8 Certificate
Click on Med8
certificate

Med8 Certificate
Enter the Insurance

number
Click on submit

Enter all the
mandatory details
Click on submit

LDC/UDC will upload certificate
Click on Upload
certificate

Uploading IMO/IMP Certificate
Click on Upload IMO IMP

Certificate

Uploading Intermediate Certificate of a continuing Spell
Enter 10 digit IP no.

Select IMO/IMP Certificate
Select the spell type
Click on Submit
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Intermediate Certificate
Intermediate certificate need to be issue for Extend the days of sickness
Fill up Mandatory
fields

Intermediate Certificate
Click on submit
Fill up the mandatory fields

Claim Creation

Claim Creation
Click on create a new

claim

Claim Creation
Enter Insurance
number
1. Provide the 10 digit Insurance No. and Press Tab from Keyboard. IP Name will be auto-populated .
2. Select Claim / Request Type as SB/ESB/TDB/MBSB.
3. Click on Submit to get the Claim Page.

Claim Creation cont…
Select the type

of claim from
dropdown

Click on submit

Click on Ok

Claim Creation cont… Ack owledg e t Ge eratio
Select ESB as a claim type

Click on generate

Click on Ok

Claim Creation cont… Ack owledg e t Successfully Ge erated

Select claim type from
dropdown
Enter from
date
Enter to
date
Click on select
acknowledgement

Click radio button

to choose the
claim
Click on submit


Click on submit
Claim Processing

Claim Processing
Click on process claim

Claim Processing cont...
Click on sickness benefit

claim processing
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01-07-2018 41
Click on task ID

Click on Next

Click on Next


Click on SB
Click on Submit to BM

Login As BM
Select user
location from drop
down menu

Select Branch
manager at
branch office

Click on
submit

Claim processing from BM login
Click on process a
claim

Click on sickness
benefit claim
processing

Click on assigned
task id

Click on next

Click on next


Click on refer the case to

MR

Click on OK


Login as MR
Select user
location from drop
down menu

Select Medical
Referee

Click on submit

Click on process
a claim

Click on
SB/TDB(ESB)

Click on task ID

Claim Processing cont...(Rate card creation)
Select disease
from drop down

Claim Processing cont...(Rate card creation)
Click on
approve

Login As BM
Select user
location from drop
down menu

Select Branch
manager at
branch office

Click on
submit

Click on process a
claim

Click on SB/TDB (ESB)

Click on task ID

Claim Processing cont...(Rate card Approval)

Click on approve

Click on ok

Rate card Approved Successfully

Click on process a
claim

Click on sickness
benefit claim
processing

Click on assigned
task id

Click on next

Click on next


Claim Processing cont...(Attaching Rate card)
Click on attach to attach the

rate card

Claim Processing cont...(Attaching Rate card)
Click on Ok

Claim is converted to ESB

Click on
approve

Click on OK

Thank You

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Extended Sickness

Last Revised on : 01-07-2018

Version 3.2 Last Revised On : 01-07-2018 2

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DA / LDC / UDC System displays the DA / LDC / UDC will

Claim Submitted to DA / LDC / UDC will DA / LDC /UDC will

MR approves Med8 BM will process a

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• For Creating ESB we need to upload the Med8 certificate first.

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Enter User name

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Scroll the mouse curser over

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Select the role as

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What are the Certificates to be uploaded for SB?

– IMO / IMP Certificate

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Enter the Insurance

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Click on Upload IMO IMP

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Enter 10 digit IP no.

Select the spell type

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Fill up the mandatory fields

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Click on create a new

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Select the type

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Select ESB as a claim type

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Click radio button

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Click on process claim

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Click on sickness benefit

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