Processing accounts

Medical/Hospital claims:

 

  • We process the claims on the same day we receive it (delivered to – or collected by us)
  • As the medical claims are being processed, we use SwitchComm to retrieve the correct information of the member and patient to ensure correctness of claims.
  • Due to the accuracy of SwitchComm there is no need to wait for feedback from the medical aids to see which claims are accepted and which not.
  • With hospital claims, we confirm the authorization numbers and ICD10 codes, with the relevant hospital/clinic, before submitting the claims.
  • All the claims are effectively processed on the correct medical aid tariff.

 

 

With private claims we do the following:

  • Get the correct tariffs at which we charge the medical practitioner.
  • We make sure the necessary patient information is correct before processing the account.
  • After processing, we send the account to the patient straightaway, with a follow-up call.

 

News

Note to all medical practitioners
January 10, 2019

Dear practitioners, please take note that due to an administrative platform change, some MEDiPOS members’ medical scheme numbers will change with effect from 1 January 2019

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