Table of Contents

Transfer KLE cases and check their status

When you choose Transfer, SwissSalary reports a new case or synchronizes a case that has already been reported. The insurer's responses update story statuses, insurance case IDs, process state, coverage, and remarks.

Prerequisites

  • The case data, insurance cases, and required stories are complete.
  • The Swissdec and KLE connection and contracts are set up for production.

Check the case before transfer

Open the KLE Case Card and check:

  • the incident or relapse date;
  • the accident or sickness type;
  • story lines that aren't marked Incomplete;
  • at least one injured body part for accidents;
  • valid KTG coverage for sickness cases;
  • no negative working hours lost;
  • no incident or relapse date in the future for production declarations.
Wichtig

Stories marked Incomplete aren't treated as ready to send. Open the story by choosing Edit Story Part, and add the missing information.

Transfer a new case

If employees enter data in SwissSalary Direct first, they must release the declaration and any attachments. The KLE data is then synchronized between Direct and SwissSalary before you check the case in SwissSalary and transfer it to the insurers.

  1. On the KLE Case Card, choose Transfer.
  2. SwissSalary checks the Swissdec connection and renews the SUA certificate if needed.
  3. The system sends the declaration story to the affected insurers.
  4. After a successful response, SwissSalary sets the case status to Reported and displays Case reported.
  5. If the Incident Date Type of an accident is Exact, SwissSalary immediately synchronizes the case to retrieve requested story parts.

You can report an accident for which Incident Date Type = Approximate or Clarification, but you can synchronize further stories only after you specify the exact date.

Synchronize a reported case

  1. Complete or answer the open story parts.
  2. Choose Transfer again.
  3. SwissSalary sends complete stories with the status Created or Requested and retrieves the response.
  4. After successful processing, Case synchronized appears.

Alternatively, on the KLE Case List, choose Transfer open cases to start KLE processing centrally.

Check story status

Status Meaning
Created The story was created in SwissSalary and hasn't been reported.
Requested The insurer expects a response or more information.
Reported The story was sent.
Confirmed The insurer confirmed the story.

Also check:

  • Job State: Success, Error, Processing, Ignored, or Verification;
  • Transfered;
  • Incomplete;
  • Expiration Date for requested responses.
Warnung

You can't delete stories and insurance cases that have already been sent in the same way as unsent drafts.

Check the insurer response

Open the insurance cases from the KLE Case List, or show the Insurance details FactBox in the KLE Case. Check:

Field Possible values or meaning
Response State Accepted, Accepted With Warning, or Rejected.
Process State Registration received, Checking declaration, Verifying claim, Performing entitlement, or Communication stopped.
Coverage No, Yes, or Unknown.
Remark Specifies additional information from the insurer.
Insurance Case ID Specifies the case reference assigned by the insurer.
Last Synchronization Specifies the time of the last successful transfer.

For Accepted With Warning, check the remarks and story comments. For Rejected, correct the master data or case information based on the response before transferring again.

Automatic synchronization

If Auto Sync Activated is turned on, SwissSalary processes reported production cases:

  • with complete stories that haven't yet been synchronized;
  • or with a last synchronization more than one week ago.

SwissSalary sets these cases to Synchronize with Next Auto-Sync = Yes and processes them through the job queue. Test cases aren't selected automatically.

Closure status

If the insurer reports the Communication stopped process state for all insurance cases, SwissSalary can automatically set the KLE case to Closed and turn on Mark as Closed. First, check open daily allowance settlements, repayments, and dialogs.

Good to know

  • Attempting to send stories with the Incomplete status — they aren't ready to send. First choose Edit Story Part.
  • Attempting to delete stories or insurance cases that have already been sent as if they were drafts — the system doesn't allow it.

See also