2. How much do procedure codes pay?
Procedure code payments vary by:
- Medical aid scheme
- Benefit option
- Contracted tariff agreement
- Whether the practice charges above or at medical aid rates
3. What should I do if a claim is partially paid or short-paid?
A short payment can occur due to co-payments, benefit limitations, or incorrect billing.
Steps to resolve:
- Open the claim in your dashboard.
- Check the Remittance Advice for the reason code.
- If the reason is unclear or incorrect, log a Billing & Payments query and attach the remittance document so our team can assist.
- If it’s a patient-responsibility amount, update the patient ledger and issue an invoice to the patient.
4. How do I handle co‑payments, shortfalls, or patient billing?
The system will automatically flag patient-responsibility amounts.
You can then:
- Generate an invoice for the patient
- Send SMS/email reminders
- Add notes for payment arrangements
If a shortfall seems incorrect, attach the remittance and log a Billing & Payments query.
5. How do I reconcile statements or track unpaid invoices?
Reconciling statements and tracking unpaid invoices requires familiarity with the system. We recommend contacting us to book a training slot as the first step. Once trained, you can use the payment reconciliation feature to:
- Export the report for auditing or patient follow-up.
- Import or view your remittance.
- Match payments to claims automatically.
- View any items not matched under outstanding claims.
6. What reports can I run to monitor practice revenue or outstanding claims?
Navigate to the Reports section in the system. You can run:
- Claim Status Report
- Patient Age Analysis
- Collection Age Analysis
- Rejected Claims Report
These help you track performance, unpaid claims, and practice cash flow trends. (Book training if needed for guidance on running and interpreting these reports.)
1. What are the typical payment run dates?
Payment run dates differ per medical aid. Most institutions process payments on a bi-weekly basis. Note that payments are only issued after successful claim submissions. If no payments have been received and no claims were submitted or billed in the system, please verify your activity and contact us if needed.