Claims & Billing Automation.
Reduce rejections. Accelerate cash flow. Stop writing off claims you should have been paid.
23% of medical aid claims in South Africa are rejected on first submission. Most of those rejections are administrative — wrong ICD-10 code, incorrect tariff, missing modifier, wrong scheme destination. Every one of them delays your cash flow by weeks or months.
Claims & Billing Automation validates every claim before submission — checking ICD-10 codes, tariff codes, modifiers, and scheme-specific rules — then routes to the correct scheme automatically. Rejections that do occur are flagged with the specific reason and a correction suggestion before they become write-offs.
ICD-10 codes, tariff codes, modifiers, and scheme rules checked before every submission
Every rejection flagged with reason code and correction suggestion — no more guessing
Claims routed to the correct scheme automatically, including co-payment structures
Reduce days-to-payment by eliminating re-submission cycles