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MediSwitch speeds up the process with real-time claims to Medscheme

17 June 2015

Claims management is now faster and more efficient for healthcare professionals making use of MediSwitch’s latest offering.

Claims submitted to Medscheme through MediSwitch will now result in an online, real-time response. This means that healthcare professionals will be aware of whether or not a claim will be covered by the patient’s medical aid scheme while he or she is still in the practice, and any shortfall can be collected immediately.

This transition to a real-time response provides improved control over administration processes and mitigates the financial risk inherent in systems that do not offer a real-time response, thereby improving cash flow.

MediSwitch already offers real-time submissions to Discovery and the Metropolitan Health Group, but previously only submitted claims to Medscheme in batch.

“Until now claims were submitted for batch processing at the end of the day, but this online service allows for the immediate delivery of a claim and for the adjudicated response to be returned instantly,” says Gary Behenna, Senior Corporate Accounts Manager for MediSwitch Central Region.

Another benefit for the healthcare professional is that this process ensures their claims have a greater chance of being included in the next pay run by the medical aid scheme, whereas delayed submissions might miss a pay run and force the practitioner to wait until the following week or pay run before receiving payment.

Healthcare professionals sending claims to MediSwitch using SwitchComm Plus, SwitchCapture, MediSwitch and SwitchOn for submission to Medscheme will all benefit from the new online real-time submission process.

SwitchOn and MediSwitch real-time users will receive immediate processed feedback to their claims, indicating the amount that Medscheme will pay or any reason for them rejecting the claim.

SwitchCapure and SwitchComm Plus users will receive their processed feedback from Medscheme via their Medres reports and MediSwitch batch users will be able to view their response messages on WEBDesk.

All MediSwitch clients have access to WEBDesk and can use this application to view their Medscheme feedback messages should they not have access to their Practice Management Application (PMA). 

“In terms of our offerings to transacting practitioners this was absolutely vital,” says Behenna. “Medscheme is one of the top medical aid scheme administrators so the inclusion of Medscheme compliments our ability to provide clients with a complete offering of online real-time claims submissions.”

The new feature does not require any software updates for the healthcare professionals already making use of MediSwitch’s services.

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