South African medical schemes process millions of pre-authorisation requests annually. The majority are routine — planned procedures with standard clinical protocols. Yet each one consumes clinical staff time that should be reserved for complex, clinically ambiguous cases.

Claims & Pre-Auth Automation triages every pre-auth request, routes routine approvals automatically against your clinical protocols, and escalates only the genuinely complex cases to your clinical team. Claims exceptions are resolved without human review where scheme rules clearly apply.