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Medical Aid Claims

Submit claims to medical aid schemes, check patient eligibility, and reconcile remittance advice — integrated with the MediKredit switching network.

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Key Capabilities

Claim Submission

Submit claims electronically via MediKredit S2PI integration. Claims pre-populated from consultation data — no re-keying.

Eligibility Checks

Verify patient medical aid membership and benefits before treatment. Know coverage status upfront.

Family Checks

Query dependant and family details from medical aid schemes to confirm patient relationships.

Transaction History

View all submitted claims, responses, and reconciliation status in one place.

ERA Processing

Upload Electronic Remittance Advice files and automatically match payments to invoices.

Claim Reconciliation

Automated matching of ERA records to submitted claims. Identify short-payments and rejections instantly.

Dispute Management

Flag disputed claims, track dispute status, and document outcomes through resolution.

Who Uses This

Admin

Oversees claims workflow, processes ERA files, manages disputes, configures switching settings.

Receptionist

Submits claims after billing, checks eligibility before appointments.

Specialist

Views claim status for own consultations.

Works With

Medical Aid Claims connects seamlessly to these other features.

Ready to get started?

R500/month · All features included · Unlimited users

14-day free trial — no credit card required

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