The Best Processing Software
Our systems and software ensures that all claims are dealt with speedily and with no delay. That is why EKB is using Elixir and MediSwitch to process the data and electronically sends it through to the Medical Aids.
Secure, fast and reliable.
M ediSwitch, who are leaders in the transmission of electronic healthcare transactions, is considered to be the best in South Africa.
EKB is using MediSwitch because:
- It improves the monthly cash flow of the practice
- It reduces unnecessary exposure to your practice/clinics’ finances
- There are less financial risks involved
- There are also less administrative hassles and expenses
EKB is using Elixir for the following reasons:
- The patient is considered to be the most vital point around the processing of a medical account. Without the patient’s details it is impossible to send the claim through via Mediswitch. Elixir is designed to simplify the capturing of information of the member/patient.
- Elixir is specifically designed to accommodate all medical practitioners, regardless of size or expertize.
- With Elixir, we keep record of the practice/clinics’ finances which enables us to provide a monthly turnover report for the well-organized management of finances.
- Elixir also caters for the dispensing and stock control requirements of any service provider.
Processing accounts
Medical/Hospital claims:
- We process the claims on the same day we receive it (delivered to – or collected by us)
- As the medical claims are being processed, we use SwitchComm to retrieve the correct information of the member and patient to ensure correctness of claims.
- Due to the accuracy of SwitchComm there is no need to wait for feedback from the medical aids to see which claims are accepted and which not.
- With hospital claims, we confirm the authorization numbers and ICD10 codes, with the relevant hospital/clinic, before submitting the claims.
- All the claims are effectively processed on the correct medical aid tariff.
With private claims we do the following:
- Get the correct tariffs at which we charge the medical practitioner.
- We make sure the necessary patient information is correct before processing the account.
- After processing, we send the account to the patient straightaway, with a follow-up call.
Submission of claims
Though most practises has developed a system for the submissions of claims, EKB have spent years of perfecting the most efficient management system, taking care of various admin functions.
Claims are therefore submitted to medical aids immediately after it has been processed. The medical aid confirms receipt within 24 hours after submission.
After the medical aid received the claims, they process the claims for payment and depending on availability of funds, the medical aid will start the payment process.
