Ere

Electronic Records Express

ERE Screen Shots - 2014

ERE

OMB: 0960-0753

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Social Security Administration

ERE Screen Shots
For OMB Clearance 0960-0753

2014

Table of Contents
Login Screen ............................................................................................................................................................................................................................................. 1
ERE Login Screen .................................................................................................................................................................................................................................. 1
Privacy Act Statement .............................................................................................................................................................................................................................. 2
ERE Homepage ......................................................................................................................................................................................................................................... 3
Administrator’s Homepage view ......................................................................................................................................................................................................... 3
Account Maintenance Screens ................................................................................................................................................................................................................ 4
Create an Individual End-User Account ............................................................................................................................................................................................... 4
Create Individual End-User Account Summary .................................................................................................................................................................................... 8
Search Accounts ................................................................................................................................................................................................................................... 9
Search Results .................................................................................................................................................................................................................................... 10
Delete Account ................................................................................................................................................................................................................................... 11
Delete Account - Account Summary .................................................................................................................................................................................................. 12
Change Your Password....................................................................................................................................................................................................................... 13
Change Your Password Confirmation ................................................................................................................................................................................................ 13
Modify Account .................................................................................................................................................................................................................................. 14
Modify Account Confirmation ........................................................................................................................................................................................................... 16
Manage Email Notification................................................................................................................................................................................................................. 17
Manage Email - Confirmation ............................................................................................................................................................................................................ 17
Evidence Services ................................................................................................................................................................................................................................... 18

Send Individual Response .................................................................................................................................................................................................................. 18
Destination and Request Information ........................................................................................................................................................................................... 18
Review & Add Information............................................................................................................................................................................................................. 19
Tracking Page ................................................................................................................................................................................................................................. 20
Submit MER Payment (non-eOR) ....................................................................................................................................................................................................... 21
Destination and Request Information ........................................................................................................................................................................................... 21
Add Invoices ................................................................................................................................................................................................................................... 22
Tracking page ................................................................................................................................................................................................................................. 23
MER No Records (eOR) .................................................................................................................................................................................................................. 24
MER No Records (eOR) - Tracking page ......................................................................................................................................................................................... 25
Send Grouped Response .................................................................................................................................................................................................................... 26
Destination Information................................................................................................................................................................................................................. 26
Review & Add Information............................................................................................................................................................................................................. 27
Confirmation .................................................................................................................................................................................................................................. 28
Review/Submit Prepared Requests ................................................................................................................................................................................................... 29
View Prepared Request and Upload Files - eOR ............................................................................................................................................................................ 30
Confirmation .................................................................................................................................................................................................................................. 32
View Prepared Request and Upload Files (Non-eOR) ................................................................................................................................................................... 33
Review & Add Information............................................................................................................................................................................................................. 34
Destination Information................................................................................................................................................................................................................. 36
Confirmation .................................................................................................................................................................................................................................. 38

Send CE Report................................................................................................................................................................................................................................... 39
Destination and Request Information ........................................................................................................................................................................................... 39
Review & Add Information............................................................................................................................................................................................................. 40
Confirmation (no fiscal).................................................................................................................................................................................................................. 41
Confirmation (with fiscal)............................................................................................................................................................................................................... 42
Send Report(s) with Scanned Signature............................................................................................................................................................................................. 43
Destination Information................................................................................................................................................................................................................. 43
Review & Add Information............................................................................................................................................................................................................. 44
Confirmation .................................................................................................................................................................................................................................. 45
Send CE No Show Response ............................................................................................................................................................................................................... 46
Destination and Request Information ........................................................................................................................................................................................... 46
Complete Reason ........................................................................................................................................................................................................................... 47
Confirmation .................................................................................................................................................................................................................................. 48
Access Electronic Requests ................................................................................................................................................................................................................ 49
Open Requests Page ...................................................................................................................................................................................................................... 49
CE Request Details/Upload ............................................................................................................................................................................................................ 50
Tracking Information (Site does not do fiscal) ............................................................................................................................................................................... 51
Tracking Information (Site does fiscal)........................................................................................................................................................................................... 52
Request Consultative Exam (CE) Payment (eOR) ............................................................................................................................................................................... 53
Patient Information ........................................................................................................................................................................................................................ 53
CE Services Performed ................................................................................................................................................................................................................... 54

Additional Services ......................................................................................................................................................................................................................... 55
Payment Information Summary..................................................................................................................................................................................................... 56
Attach and Upload Invoices ........................................................................................................................................................................................................... 57
Tracking page ................................................................................................................................................................................................................................. 58
Access Provider’s Electronic Requests ............................................................................................................................................................................................... 60
Access Provider’s Electronic Requests – Open Requests............................................................................................................................................................... 60
View/Submit Consultative Examination (CE) Request – Prepare Report for Provider (eOR) ........................................................................................................ 61
Tracking Information ...................................................................................................................................................................................................................... 62
Communication Services ........................................................................................................................................................................................................................ 63
Messaging Services ............................................................................................................................................................................................................................ 63
Secure Messaging - Inbox .............................................................................................................................................................................................................. 63
Compose Message ......................................................................................................................................................................................................................... 64
Compose Message – Confirmation ................................................................................................................................................................................................ 65
Communication Utility ....................................................................................................................................................................................................................... 66
Send Message and Files ................................................................................................................................................................................................................. 66
Confirmation .................................................................................................................................................................................................................................. 67

Login Screen
ERE Login Screen

1|Page

Privacy Act Statement

See Revised Privacy Act Statement Attached

2|Page

ERE Homepage
Administrator’s Homepage view

3|Page

Account Maintenance Screens
Create an Individual End-User Account

4|Page

5|Page

Manage End-User Relationships

6|Page

Manage End-User Relationships – Search Results

7|Page

Create Individual End-User Account Summary

8|Page

Search Accounts

9|Page

Search Results

10 | P a g e

Delete Account

11 | P a g e

Delete Account - Account Summary

12 | P a g e

Change Your Password

Change Your Password Confirmation

13 | P a g e

Modify Account

14 | P a g e

15 | P a g e

Modify Account Confirmation

16 | P a g e

Manage Email Notification

Manage Email - Confirmation

17 | P a g e

Evidence Services
Send Individual Response
Destination and Request Information

18 | P a g e

Review & Add Information

19 | P a g e

Tracking Page

20 | P a g e

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

21 | P a g e

Add Invoices

22 | P a g e

Tracking page

23 | P a g e

MER No Records (eOR)

24 | P a g e

MER No Records (eOR) - Tracking page

25 | P a g e

Send Grouped Response
Destination Information

26 | P a g e

Review & Add Information

27 | P a g e

Confirmation

28 | P a g e

Review/Submit Prepared Requests

29 | P a g e

View Prepared Request and Upload Files - eOR

30 | P a g e

31 | P a g e

Confirmation

32 | P a g e

View Prepared Request and Upload Files (Non-eOR)

33 | P a g e

Review & Add Information

34 | P a g e

Confirmation

35 | P a g e

Prepare Report for Provider
Destination Information

36 | P a g e

Review & Add Information

37 | P a g e

Confirmation

38 | P a g e

Send CE Report
Destination and Request Information

39 | P a g e

Review & Add Information

40 | P a g e

Confirmation (no fiscal)

41 | P a g e

Confirmation (with fiscal)

42 | P a g e

Send Report(s) with Scanned Signature
Destination Information

43 | P a g e

Review & Add Information

44 | P a g e

Confirmation

45 | P a g e

Send CE No Show Response
Destination and Request Information

46 | P a g e

Complete Reason

47 | P a g e

Confirmation

48 | P a g e

Access Electronic Requests
Open Requests Page

49 | P a g e

CE Request Details/Upload

50 | P a g e

Tracking Information (Site does not do fiscal)

51 | P a g e

Tracking Information (Site does fiscal)

52 | P a g e

Request Consultative Exam (CE) Payment (eOR)
Patient Information

53 | P a g e

CE Services Performed

54 | P a g e

Additional Services

55 | P a g e

Payment Information Summary

56 | P a g e

Attach and Upload Invoices

57 | P a g e

Tracking page

58 | P a g e

59 | P a g e

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

60 | P a g e

View/Submit Consultative Examination (CE) Request – Prepare Report for Provider (eOR)

61 | P a g e

Tracking Information

62 | P a g e

Communication Services
Messaging Services
Secure Messaging - Inbox

63 | P a g e

Compose Message

64 | P a g e

Compose Message – Confirmation

65 | P a g e

Communication Utility
Send Message and Files

66 | P a g e

Confirmation

67 | P a g e

SSA will insert the following revised Privacy Act Statement into the screens upon OMB approval:

Privacy Act Statement

Section 205(a) [42 U.S.C. 405] of the Social Security Act, as amended, authorizes us to collect
this information to allow you access to our Business Services Online (BSO).

2|Page


File Typeapplication/pdf
File TitleMicrosoft Word - ScreenShotPackageForOMB_2014 08 doc (2).doc
Author177717
File Modified2014-08-21
File Created2014-08-21

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