We take over your claims processing activities, follow-up with medical aids and patient liable payments in its totality, so you can focus on your practice and/or patients
We handle your debtors/medical aid claims on behalf of your practice anywhere in South Africa, by providing all the services detailed below.
We will change your contact details with the medical schemes to receive your remittances from them directly to ensure speedy processing of payments and solving of rejections.
Assist you with updating your bank details with the various medical aids if you are a new practice and not yet registered with them.
Capturing the patient’s data as well as the transaction codes, ICD10 codes, referring doctor and referring doctor ICD10 codes.
Verifying whether the patient data we have received is correct, ensuring less claim rejections.
Submitting claims electronically (EDI) to medical schemes, making sure you get paid as fast as possible.
If the medical aid does not pay the claim in full we will send statements to the patient by email with the rejection reason on the account.
SMS'ing patients (who are liable), reminding them to pay outstanding amounts until the account is paid. A link to an electronic statement is included in the SMS allowing the patient to view their statement without access to a computer or email.
Phoning medical aids and following up on any outstanding claims from 30 days.
As a last resort patients that do not pay their outstanding fees are sent an ITC letter. Patients that do not respond are then listed on ITC.
Certain practices will receive monthly reports for reconciliation purposes, but transaction and payment information is available to all clients in real-time in the client area when logged in, largely negating the need for such reports.
Payments from the patient or medical aid will be deposited directly into the practices bank account, not via Dentelle.
You don’t need costly new software, hardware or extra personnel!
Just supply us with the patient details and your invoice which can be emailed or faxed to us, and we'll do the rest!