SA Health - Young Male Doctor with Staff
SA Health - Young Indian Male Doctor with Staff
SA Health - Young Female Doctor with Colleagues
SA Health - Medical Team
SA Health - Smiling Female Nurse with Medical Clipboard

Do You Have a Question?

Frequently Asked Questions

What is the benefit in using 'SA Health' services?

Outsourcing your billing is an effective way to use our expertise in medical billing to save you time and administration overheads. Our small processing fee is charged only when payment is recovered, which means we only get paid when you do.

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Is there a registration fee?

There is NO Fee for registering with 'SA Health'.

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What systems do you use?

We will submit your claims to the respective Medical aid directly using a real time software such as(MEDEDI). The benefits paid for your claims will always be transferred directly into your nominated bank account.

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Does money collected go into my account or yours?

Benefits paid for your claims will always be transferred directly into your nominated bank account. Unlike some organisations which hold onto your money in their trust accounts, there is absolutely no lag time. You have access to the income you have generated as soon as the medical aid transfers it to your nominated bank account. Plus because we have well-established communication channels with all the medical aids, the process is expedited – it’s quicker than doing it yourself or training your clinic staff to do it and when required we also follow up on rejected, unpaid or underpaid claims on your behalf.

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What is the turn around time for processing my claims?

'SA Health' will submit your claims to the respective medical aid within 24 hours of it being received by our staff. If you’ve done a ward round on Tuesday and sent through the information to us that day, your claims will be submitted to the respective Medical aid on Wednesday. Once sent, payments will start appearing in your bank account within 10-15 days depending on the medical aid payment run. There’s only one exception: a very small number of claims are held up or rejected by the funds. They may require more information or amended details to proceed. If there is such a claim in your batch, it will not delay payment of your other claims. We will investigate and ensure that your rejected claim is reassessed by the Medical aid. We may also contact you if there is any additional information required to assess the claim.

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How do you manage arrears?

That is our expertise, we understand the medical aids policies and procedures, who to contact and the appropriate language used in the industry to expedite payments and avoid delays. We mediate between your needs and their requirements. Each of the Medical aids has its own specific way of doing business. Take advantage of the specialised knowledge we have and leave us to liaise with the Medical aids on your behalf to get your claims paid promptly. We are in daily contact with medical aids and we are vigilant about pursuing your interests. If you have any outstanding claims, we will keep you advised about their status through our monthly reporting.

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Once I hand information to ‘SA Health, how do I know what’s going on?

As soon as we receive your medical billing service details from you, we will confirm this by email and by text so you are confident that the claims payment process on your behalf is underway. We are here to help you and we understand you are busy so if you require to access your billing details you can contact us or you can access our program remotely; • Monday to Friday from 8.00am to 5.00pm And like any good financial tracking system, details are constantly updated for each action taken. You won’t need to sidetrack staff to pull files or go searching to locate documents. No bits of paper to worry about losing. You never lose control over your billing we are here to take care of it for you so you can concentrate on the treatment of your patients. We keep a record on file of all information you send us and you can request a copy of it any time.

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If I need to see some of the information I sent to you what do I do?

All you have to do is let us know the name of your patient and we will send a copy of the account to you. Your records are securely filed at ‘SA Health’ so you can access our program remotely 24hrs /request a copy of your accounts at any time. We will send these requests to you by email, fax or mail, just let us know your preference.

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How do I get my billing information to you?

We provide you with an electronic or hard copy template of our In-Patient Medical Billing Service form, all you will need to do is fill in this form with your claim details and fax, email or post it to us or we can fetch it. – It’s that easy. If you wish you can send your claim details to us on a spread sheet. We are Flexible Because we know that billing is the bane of your practice, we want to make the procedure as easy and convenient as possible – for you. You can help us speed the process of submitting your claim by filling in all required information on our In-Patient Medical Billing Service Form e.g. Patient’s full name, date of birth, Medical aid card and reference as well as patient Medical aid and membership number. Please ensure that your patient details include: Patient’s full name, date of birth, Medical aid card and reference also Medical aid and membership number. Please note that it is not mandatory that you use our medical billing service sheets but it is certainly preferred.

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What if I miss some Information on the Billing service form?

That is what we are here for. So don’t worry we will contact the hospital, Medical aid or your patient to retrieve all required details.

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What if the claim details I am sending is compensation related?

Prior to submitting your in-patient compensation related claim details to ‘SA Health’ we recommend that you obtain a copy of the approval letter issued by the Medical aid to the patient. This will ensure that in the future you do not receive a request to refund benefits to Medicare or the Medical aid. Please note that these claims may be delayed due to the policy and procedures held by Medical aids.

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Where can I obtain an In-Patient Billing Service form?

You can download it from our website at……………………. or you can contact us to request it and we can email, fax or post it to you.

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How often should I send through my billing information?

This is up to you. Mostly doctors choose to send through their medical billing information every day or every few days. As soon as you pass it on to us, you don’t have to worry about it anymore. We take care of everything. The next step, for you, will be to check the payment into your nominated bank account by the Medical aids/patients. The sooner we receive your claims details, the quicker you get paid.

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How much do you charge?

We charge a 5.5% fee of the funds paid to you for the in-patient medical claims we submit on your behalf each month. This is based on the amount that is actually banked into your nominated bank account for in-patient medical claims submitted by ‘SA Health’ on a monthly basis. This means that if there is any extra work to process an account, that’s our problem. Not yours. There are no hidden costs awaiting you at the end of the month. We don’t charge a flat fee so if you’re not generating much billing, you’re not paying much either. There are also no retaining fees or start up fees. We only charge when we have successfully received payment of a claim for you in the current month. If nothing is banked into your account in a particular month, ‘SA Health’ does not charge you a fee. No Claims – No Fees. We can guarantee that by using ‘SA Health’ you will save significantly on your current administration costs by using our services and allowing us to submit your accounts and follow up any outstanding accounts on your behalf.

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What about confidentiality of the information I provide to ‘SA Health’?

All information that is communicated to ‘SA Health’ about both clients and patients is treated in the strictest confidence. No one, apart from ‘SA Health’ staff, is permitted access to any information held by the organisation. Rest assured that ‘SA Health’ adheres to all relevant legislation regarding confidentiality of patient records and patient information.

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What billing methods can I use?

Whatever suits you, We have experience in all types of medical claiming used throughout South Africa.

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If I only see a few private patients each month, can I still use ‘SA Health’?

Yes you can. No client is too small. In fact, it is often those specialists who see only a few private patients who do not have the established resources to deal with in-patient medical billing. We’re always happy to help.

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How do you follow up on accounts issued to the patient?

  1. First reminder – on expiry of the account due date;
  2. Second reminder – 14 days or as soon as practicable after the first reminder;
  3. Third reminder – 10 days after the second reminder;
  4. If there is no payment following the 3rd reminder letter, ‘SA Health’ will consult the client for approval to either:
    1. Write-off the debt; or
    2. Refer the issue to a formal debt collection agency (cost passed to you or to your patient according to your instructions).
  5. Debt recovery action:
    1. Debt recovery warning letter;
    2. Debt recovery action, 7 days after warning letter.
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What reports do you provide?

Monthly reports summaries are provided to all clients. Monthly reports include:

  • accounting summary;
  • medical billing summary;
  • payment summary by Medical aid; and
  • Details of outstanding claims
Every month you will receive a detailed list of all patients, item numbers and amounts we have billed for you, exactly what we have collected on your behalf and what remains outstanding. We are happy to provide additional reports or tailor reports to suit your needs.

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If I join ‘SA Health’, am I locked in?

You are free to leave anytime. We understand that your circumstances may change and we will assist you to make the transition to your new arrangements as smooth as possible. Because it costs you nothing to join and nothing to leave, you can try ‘SA Health’ at any time and see how it works for you. We’re convinced you’ll wish you’d done it sooner!

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