Medical Aid Billing Services
Our Medical Aid Billing Services are designed to streamline revenue cycle management for healthcare professionals and medical practices. We provide accurate claim processing, medical aid verification, payment reconciliation, rejection management, patient billing, and comprehensive administrative support to ensure efficient operations, improved cash flow, and maximum reimbursement. By delivering reliable, compliant, and professional billing solutions, we enable healthcare providers to focus on delivering exceptional patient care while we manage the complexities of the billing process.
1. Patient Registration
Capturing patient information.
Verifying medical aid membership details.
Checking benefits and eligibility before treatment.
2. Medical Aid Verification
Confirming the patient's:
Medical aid scheme.
Plan option.
Available benefits.
Co-payments.
Annual limits.
Waiting periods.
3. ICD-10 & Procedure Coding
Assigning the correct:
ICD-10 diagnosis codes.
Procedure or treatment codes.
Ensuring claims comply with medical aid requirements.
4. Claim Submission
Preparing and submitting claims electronically to medical aid schemes.
Ensuring all required information is included.
10. Reporting
Providing reports such as:
Outstanding claims.
Rejected claims.
Monthly revenue.
Payments received.
Age analysis of debtors.
Collection performance.
11. Compliance
Helping practices comply with:
ICD-10 coding standards.
Medical aid billing rules.
POPIA (Protection of Personal Information Act).
Relevant healthcare regulations.
12. Practice Management Support
Some billing providers also assist with:
Appointment scheduling.
Patient records management.
Electronic medical records (EMR/EHR).
Billing software management.
Administrative support.
Our billing services deal with claims submitted to schemes such as but not limited to: Discovery Health, Bonitas, Momentum Health, Fedhealth, Bestmed, Medihelp, GEMS, Profmed, Sizwe Hosmed, Polmed
Who Needs our Medical Aid Billing Services?
General Practitioners (GPs)
Specialists
Dentists
Physiotherapists
5. Rejected Claim Management
Investigating rejected or unpaid claims.
Correcting errors.
Resubmitting claims promptly.
6. Payment Reconciliation
Matching payments received from medical aids with submitted claims.
Identifying underpayments or outstanding balances.
7. Patient Billing
Sending invoices to patients for:
Co-payments.
Deductibles.
Services not covered by medical aid.
Outstanding balances.
8. Debt Collection Follow-up
Following up on unpaid patient accounts.
Sending reminders.
Arranging payment plans where necessary.
9. Medical Aid Authorisations
Obtaining pre-authorisation for procedures, surgeries, scans, or hospital admissions when required.