At this stage, Bookem does not natively deal with real-time medical aid claims, also known as EDI or switching.
However, we have partnered with a medical billing bureau that specialises in medical billing. We call this our Medical Billing Service. Our services include, but are not limited to:
Authorisations for in-hospital claims: we obtain and load auth's 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 auth's are updated for the dates that you have treated in hospital, and update auth's 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 recon and allocate money received against relevant accounts from your bank statements or medical aid remittance advices or cash payments, etc.
Handling of 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.
Monthly status reports: we send you monthly management reports, i.e. age analysis, invoice details, transaction analysis, etc.
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. More importantly, practices find that we would improve their cashflow by optimising the claims and collections process.
The way we make money is by charging 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.
Because we charge this way, our team is incentivised to get invoices settled as fast as possible.
To get a quote with more details, send us a mail at firstname.lastname@example.org.