Unique and efficient recovery. |
 We offer specialist medical benefit recovery services. The service which we have to offer is unique in that it is an administrative function designed to recover the maximum medical benefits paid by the Medical Aid Scheme. Sifting and identification of possible claims Implementing a sifting procedure to identify possible recoverable claims, assist the member by assessing the viability of a claim, offering the member legal representation if required, obtaining undertaking from the member to re-pay the medical on successful settlement of their claim. Obtaining of original accounts (EDI accounts) Retrieval of “original accounts” which are required to recover amounts in terms of the claim, from the suppliers that submitted their accounts electronically. Compilation of schedules and supporting vouchers Compiling of schedules for the past medical expenses pertaining to the incident paid by the Medical Aid Scheme with the supporting vouchers for submission to the liable party. Follow up the recovery/progress of claims instituted Obtaining quarterly progress reports of the claim. Ensuring that the Medical Aid is repaid the medical expenses recovered from the liable party. Customer Service Handle all claim related queries in an efficient and professional manner. Reporting Full reports on claims and receipting provided monthly.
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