Ere

Electronic Records Express

ERE Screen Package - Revised

ERE

OMB: 0960-0753

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Social Security Administration

SEPTEMBER 2020 ERE Screen Shots

For OMB Clearance 0960-0753

1

Table of Contents
ERE Login ..................................................................................................................................... 1
Login Screen ............................................................................................................................... 1
Private Act Statement ................................................................................................................. 2
ERE Home Page ............................................................................................................................ 3
Administrator’s Home Page View .............................................................................................. 3
Individual End-User Home Page View....................................................................................... 4
Account Services ........................................................................................................................... 5
Create an Individual End-User Account ..................................................................................... 5
Basic Information.................................................................................................................... 5
Organization Information........................................................................................................ 6
Review .................................................................................................................................... 7
Confirmation ........................................................................................................................... 8
Duplicate e-Mail warning message for multiple ERE accounts ............................................. 8
Manage End-User Relationships................................................................................................. 9
Search Criteria ........................................................................................................................ 9
Search Results ....................................................................................................................... 10
Create Individual End-User Account Summary ................................................................... 11
Search Accounts........................................................................................................................ 12
Search Page ........................................................................................................................... 12
Search Results ....................................................................................................................... 13
Delete Account.......................................................................................................................... 14
Delete Account Summary ..................................................................................................... 15
Change Your Password ............................................................................................................. 16
Change Your Password Confirmation .................................................................................. 16
Modify Account ........................................................................................................................ 17
Modify Account Confirmation ............................................................................................. 20
Manage E-Mail Notification ..................................................................................................... 21
Manage E-Mail Notification Confirmation .......................................................................... 21
Evidence Services ........................................................................................................................ 22
Send Individual Response ......................................................................................................... 22
Destination and Request Information ................................................................................... 22
i

Review & Add Information .................................................................................................. 23
Tracking Page (no fiscal) ...................................................................................................... 24
Tracking Page (fiscal) ........................................................................................................... 25
Send Grouped Response ........................................................................................................... 26
Destination Information ........................................................................................................ 26
Review & Add Information .................................................................................................. 27
Confirmation ......................................................................................................................... 28
Send CE Report......................................................................................................................... 29
Destination & Request Information ...................................................................................... 29
Review & Add Information .................................................................................................. 30
Tracking Page (no fiscal) ...................................................................................................... 31
Tracking Page (with fiscal) ................................................................................................... 32
Send CE Report(s) with Scanned Signature ............................................................................. 33
Destination Information ........................................................................................................ 33
Review & Add Information .................................................................................................. 34
Confirmation ......................................................................................................................... 35
Send CE No Show Response .................................................................................................... 36
Destination and Request Information ................................................................................... 36
Review & Add Information .................................................................................................. 37
Tracking Page (no fiscal) ...................................................................................................... 38
Tracking Page (fiscal) ........................................................................................................... 39
Prepare CE Report for Provider ................................................................................................ 40
Destination Information ........................................................................................................ 40
Review & Add Information .................................................................................................. 41
Tracking Page ....................................................................................................................... 42
Access Electronic Requests ...................................................................................................... 43
Open Requests Page .............................................................................................................. 43
View / Submit CE Request – Upload Files ........................................................................... 44
Tracking Page – Upload Files (Site does not do fiscal) ........................................................ 47
View / Submit CE Request – No Show Response ................................................................ 48
Tracking Page – No Show Response (Site does not do fiscal) ............................................. 50
Tracking Page – Upload Files (Site does fiscal) ................................................................... 51
ii

Submit Payment Request for CE .............................................................................................. 52
Patient Information ............................................................................................................... 52
Services Performed ............................................................................................................... 54
Review – Upload Invoices .................................................................................................... 56
Add Invoices ......................................................................................................................... 58
Tracking Page – Uploaded Invoices ..................................................................................... 59
Review – No Invoices to Upload .......................................................................................... 62
Tracking Page – No Invoices Uploaded ............................................................................... 64
View / Submit Evidence Request – Upload Records............................................................ 67
Tracking Page – Upload Records (Site does not do fiscal) .................................................. 69
Tracking Page – Upload Records (Site does fiscal).............................................................. 70
View / Submit Evidence Request – No Records .................................................................. 71
Tracking Page – No Records (Site does not fiscal) .............................................................. 73
Tracking Page – No Records (Site does fiscal) .................................................................... 74
Submit Payment Requests for MER ......................................................................................... 75
Patient Information ............................................................................................................... 75
Review – Upload Invoices .................................................................................................... 77
Upload Invoices .................................................................................................................... 78
Review – No Invoices ........................................................................................................... 79
Upload Invoices Tracking Page ............................................................................................ 81
No Invoices Tracking Page ................................................................................................... 83
Access Provider’s Electronic Requests ..................................................................................... 85
Access Provider’s Electronic Requests – Open Requests..................................................... 85
View / Submit CE Request ................................................................................................... 86
Tracking Page ....................................................................................................................... 88
Review / Submit Prepared Requests ......................................................................................... 89
List of Requests..................................................................................................................... 89
non-eOR - Patient Information & Destination and Request Information ............................. 90
non-eOR - Review & Add Files............................................................................................ 91
non-eOR - Tracking Page ..................................................................................................... 93
eOR - Review and Add Files ................................................................................................ 94
eOR – Tracking Page ............................................................................................................ 96
iii

Messaging Services...................................................................................................................... 97
Secure Messaging ..................................................................................................................... 97
Inbox ..................................................................................................................................... 97
Compose Message ................................................................................................................ 98
Search Contacts ..................................................................................................................... 99
Compose Message – Confirmation ..................................................................................... 100
Contact OHO Office ............................................................................................................... 101
Send Message and Files ...................................................................................................... 101
Confirmation ....................................................................................................................... 102
Payment Services ...................................................................................................................... 103
Submit Payment Request (non-eOR) ...................................................................................... 103
MER - Destination and Request Information ..................................................................... 103
MER - Add Invoices ........................................................................................................... 104
MER - Tracking Page ......................................................................................................... 105
CE - Destination and Request Information ......................................................................... 106
CE – Add Invoices .............................................................................................................. 107
CE – Tracking Page ............................................................................................................ 108
Access Provider’s Electronic Requests ................................................................................... 109
Open Payments (no reports submitted yet) ......................................................................... 109
Open Payments (report submitted) ..................................................................................... 110

iv

ERE Login
Login Screen

1

Private Act Statement

See Revised Privacy Act
Statement attached

2

SSA will insert the following revised Privacy Act Statement into the collection as
soon as possible:
Privacy Act Statement
Collection and Use of Personal Information

Section 205 of the Social Security Act, as amended, allows us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the
information may prevent you from registering with Electronic Records Express (ERE) or
electronically submit reimbursement requests.
We will use the information to register you to use ERE, collect medical or education records, or
disburse payment. We may also share your information for the following purposes, called
routine uses:
•

To student volunteers, individuals working under a personal services contract, and other
workers who technically do not have the status of Federal Employees, when they are
performing work for SSA, as authorized by law, and they need access to personally
identifiable information (PII) in SSA records in order to perform their assigned agency
functions; and

•

To applicants, claimants, prospective applicants or claimants, other than the data subject,
their authorized representatives or representative payees to the extent necessary to pursue
Social Security claims and to representative payees when the information pertains to
individuals for whom they serve as representative payees, for the purpose of assisting
SSA in administering its representative payment responsibilities under the Social Security
Act and assisting the representative payees in performing their duties as payees, including
receiving and accounting for benefits for individuals for whom they serve as payees.

In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notice
(SORN) 60-0320, entitled Electronic Disability (eDib) Claim File, as published in the Federal
Register (FR) on June 4, 2020, at 85 FR 34477 and 60-0089, entitled Claims Folders System, as
published in the Federal Register (FR) on October 31, 2019, at 84 FR 58422. Additional
information and a full listing of all our SORNs are available on our website at
www.ssa.gov/privacy/.

ERE Home Page
Administrator’s Home Page View

3

Individual End-User Home Page View

4

Account Services
Create an Individual End-User Account
Basic Information

5

Organization Information

6

Review

7

Confirmation

Duplicate e-Mail warning message for multiple ERE accounts

8

Manage End-User Relationships
Search Criteria

9

Search Results

10

Create Individual End-User Account Summary

11

Search Accounts
Search Page

12

Search Results

13

Delete Account

14

Delete Account Summary

15

Change Your Password

Change Your Password Confirmation

16

Modify Account

17

18

19

Modify Account Confirmation

20

Manage E-Mail Notification

Manage E-Mail Notification Confirmation

21

Evidence Services
Send Individual Response
Destination and Request Information

22

Review & Add Information

23

Tracking Page (no fiscal)

24

Tracking Page (fiscal)

25

Send Grouped Response
Destination Information

26

Review & Add Information

27

Confirmation

28

Send CE Report
Destination & Request Information

29

Review & Add Information

30

Tracking Page (no fiscal)

31

Tracking Page (with fiscal)

32

Send CE Report(s) with Scanned Signature
Destination Information

33

Review & Add Information

34

Confirmation

35

Send CE No Show Response
Destination and Request Information

36

Review & Add Information

37

Tracking Page (no fiscal)

38

Tracking Page (fiscal)

39

Prepare CE Report for Provider
Destination Information

40

Review & Add Information

41

Tracking Page

42

Access Electronic Requests
Open Requests Page

43

View / Submit CE Request – Upload Files

44

45

46

Tracking Page – Upload Files (Site does not do fiscal)

47

View / Submit CE Request – No Show Response

48

49

Tracking Page – No Show Response (Site does not do fiscal)

50

Tracking Page – Upload Files (Site does fiscal)

51

Submit Payment Request for CE
Patient Information

52

53

Services Performed

54

55

Review – Upload Invoices

56

57

Add Invoices

58

Tracking Page – Uploaded Invoices

59

60

61

Review – No Invoices to Upload

62

63

Tracking Page – No Invoices Uploaded

64

65

66

View / Submit Evidence Request – Upload Records

67

68

Tracking Page – Upload Records (Site does not do fiscal)

69

Tracking Page – Upload Records (Site does fiscal)

70

View / Submit Evidence Request – No Records

71

72

Tracking Page – No Records (Site does not fiscal)

73

Tracking Page – No Records (Site does fiscal)

74

Submit Payment Requests for MER
Patient Information

75

76

Review – Upload Invoices

77

Upload Invoices

78

Review – No Invoices

79

80

Upload Invoices Tracking Page

81

82

No Invoices Tracking Page

83

84

Access Provider’s Electronic Requests
Access Provider’s Electronic Requests – Open Requests

85

View / Submit CE Request

86

87

Tracking Page

88

Review / Submit Prepared Requests
List of Requests

89

non-eOR - Patient Information & Destination and Request Information

90

non-eOR - Review & Add Files

91

92

non-eOR - Tracking Page

93

eOR - Review and Add Files

94

95

eOR – Tracking Page

96

Messaging Services
Secure Messaging
Inbox

97

Compose Message

98

Search Contacts

99

Compose Message – Confirmation

100

Contact OHO Office
Send Message and Files

101

Confirmation

102

Payment Services
Submit Payment Request (non-eOR)
MER - Destination and Request Information

103

MER - Add Invoices

104

MER - Tracking Page

105

CE - Destination and Request Information

106

CE – Add Invoices

107

CE – Tracking Page

108

Access Provider’s Electronic Requests
Open Payments (no reports submitted yet)

109

Open Payments (report submitted)

110


File Typeapplication/pdf
AuthorShah, Dhaval K.
File Modified2020-12-04
File Created2020-07-17

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