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Data capturing and billing Process

  • Correct submitting of all claims electronically via EDI. Correct data capture including - membership validation details, member option and confirming patient information.
  • Billing according to membership option, billing guide line and according to medical aid contract billing  (payment agreements). 

Credit Controlling Process

  • Following up with medical aid in confirming receiving account, confirm amount accepted for processing. If any rejection on day to day benefits member to be informed on outstanding accounts Following up on any rejections, short payments and submitting any documents in regards of short fall on account - i.e. Letter of Motivation, referral letters.
  • Following up with patients on any short payments because of day to day benefits exhausted.
  • Posting account to member informing member that account needs to be settled in 30 days.
  • Private accounts are followed up on the day of billing Guarantor is informed on the day about outstanding amount, requesting email address to email account and informing them account needs to be settled in 7 days. If international funds, all required documents are posted/emailed to Guarantor for quick and easy payment result.

Debtors Process

  • Allocating payments to correct service date as per remittances from the medical aids and from patients on a weekly basis ( payment will be made to the practice bank )
  • Monthly reconciliations on all accounts to ensure all account are processed correctly and that account are on zero balance to close account.


 
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