Submit Accurate Medical Aid Claims For Your Healthcare Practice
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FREQUENTLY ASKED QUESTIONS

How does MediRates help your practice be profitable?

Ensuring that the claims you submit are accurate to the cent is vital to the profitability and cashflow of your practice. Previously practitioners relied on calling the medical aids, downloading various formats or just adding a percentage increase and hoping for the best. Even the companies claiming to handle the tariffs for you are just working on a best guess basis. Every rejected claim costs your practice money and forces you to hassles your patients.

MediRates reduces all these hassles and minimises these loses by providing your practice with one place to get all the correct tariffs. By working directly with the medical schemes and their administrators we make every effort to get the correct tariffs from the source and as soon as they are finalised. We also make it available online so you can check tariffs at any stage or just download in a variety of supported formats for import into your PMA.

How does MediRates save you time?

Apart from saving time on trying to get all the published medical schemes tariffs and then handling the formats MediRates also customises the tariff for your practice. This means that you will only see the tariffs which are relevant to your practice based on your discipline type and the contracts you’ve signed with the medical schemes. Once you’ve completed the quick setup process you will no longer waste time trying to figure out which tariff is actually applicable to you for a specific procedure code.

How many accounts does my practice require?

For most practices the answer is generally just one. MediRates doesn’t charge extra when multiple practitioners are part of the same practice. This is due to the fact that the billing profile for the practitioners is identical. MediRates creates a customised tariff profile for each registered account which is based on the discipline type and the contracts for each of the medical schemes that the practitioner has signed. This is part of our service to the practice to reduce the complexity to only relevant tariffs.

However, if you represent multiple practitioners who are spread across multiple discipline types and/or have signed different contracts with the medical schemes then multiple accounts will be required and will be charged accordingly. If you wish to find out more about how that works then please contact our sales team on sales@medirates.co.za and we will assist you in working out a package that makes sense for your organisation.

Examples:

A Group practice with 3 GPs with exactly the same scheme contracts: 1 Account

A Dental practice with a dentist and dental technician with same scheme contracts: 2 Accounts (2 discipline types)

A specialist with own scheme contracts billing through a bureau: 1 Account (Bureau will require your customised tariff profile)

What about my private/cash clients?

Nearly all practices have their private tariffs and some don’t even do any direct billing. MediRates supports this by allowing your practice to capture their private rates against the procedure codes. Using the lookup system MediRates will automatically calculate the co-payments your patient will be liable for based on their medical aid. This means that you and your staff can inform your patients of what their scheme will repay and what their co-payment would be. This will help your patients in making informed decisions.

What happens with changes?

As soon as MediRates is informed of any tariff changes the system will automatically notify you with the latest information. However, because of your customised profile you will only be notified if the tariff change is actually relevant to you practice. This reduces the noise and helps you focus on what is necessary. Also if your contract agreements change during the year you can contact the MediRates support team to adjust your practice setup so that the new contract tariffs become visible to you.

How do I put the tariffs into my PMA?

MediRates is working in conjunction with many of the industry leading PMAs in order to make this process as simple and seamless as possible. By providing your customised tariffs in a variety of formats you should be able to download the tariff file to you desktop and then import it straight into your local system. For assistance with specific PMAs please contact your chosen software vendor directly.