At this stage, Bookem does not natively deal with real-time medical aid claims, also known as EDI or switching. This will change in 2024.
However, we have partnered with a so-called bureau that specialises in medical billing. We call this our Medical Billing Service.
For practices using this service, our remote team issues invoices and medical aid claims on behalf of your practice using real-time medical aid switching. Read below for details on how this works.
Authorisations for in-hospital claims: We obtain and load authorisations on the system, liaise with hospital case managers to ensure they update the cases with the case managers at the medical fund, liaise with medical aids to ensure authorisations are updated for the dates that you were treated in hospital, and update authorisations on the system. No in-hospital claim is sent to medical aid without authorisation.
Invoicing of claims: We invoice claims and send directly to medical aid via EDI and get real-time feedback or send claims to patients directly should they not have medical aid.
Rejections of claims: we investigate each rejection of claims submitted to the medical aids and remedy the situation or move it to a member liable state and inform the member of the account.
Accounts outstanding (medical aids): we liaise with medical aids on outstanding accounts to sort out various issues with medical aid come-backs.
Accounts outstanding (patients): we follow up with patients to pay their accounts.
Processing of receipts: we reconcile and allocate money received against relevant accounts from your bank statements, medical aid remittance advices, cash payments, etc.
All queries: we handle all account queries from your patients, either via incoming emails via Bookem's patient email inbox or otherwise.
Bad debt: we investigate all bad debt that your practice might have and, if possible, we will collect the bad debt for you.
The preparation of monthly status reports: we send you monthly management reports, i.e. age analysis, invoice details, transaction analysis, etc.
Determining salaries & commissions: we run reports and calculate salaries and commissions for practitioners.
We are very efficient in this process, saving your practice and employees a lot of time that can instead be spent focussing on other facets of your practice.
We charge you a fixed percentage of money that clears in your account, or a monthly minimum, whichever is the greater. Your Bookem subscription is included in this cost. In other words, as a medical billing client you would get Bookem for free.
Because we charge only for invoices that are actually paid, our team is incentivised to get invoices settled as fast as possible.
To get a quote with more details, send us a mail at [email protected].