Benefit Checker (Health Policy Query)

Introducing a suite of electronic services which will have endless benefits in your practice. This suite of services creates seamless efficiency by decreasing the time taken to check member eligibility, confirm benefits, submit real-time claims and reconcile electronic remittance advices.

Practice Manager Connect is your solution to a healthier practice. It provides a real-time service experience which means less frustration and more convenience overall.

Your practice will also benefit from:

  • The ability to submit claims quicker, which will result in faster payment
  • Claim decisions in real time
  • Automatic claim reconciliations
  • Overall better experience for patients

It would be like having a Discovery Health specialist sitting at the front desk.

Member Validation

With this membership check, your practice will have information at hand specific to each patient’s membership on Discovery Health Medical Scheme and the schemes administered by Discovery Health:

  • Their membership status
  • The patient’s chosen health plan
  • Hospital authorisations
  • Available day-to-day benefits.

Virtual Quote

You can then send a simulated claim to get a quote in real time that will confirm how the Scheme will pay the services your practice provides. You will be able to see:

  • Funding details for your practice
  • Amounts the patient will have to pay or not pay
  • Reasons for any partial payments.

The information provided would allow for an informed decision about submitting the claim.

Realtime Claims

Your practice can submit a claim and immediately find out in real time whether your patients have money available in their Medical Savings Account and what amount the Scheme will pay. You can then let your patients know right at your rooms and finalise payment.

ERA - Electronic Remmitance Advice

No more manual reconciliations. Practice Manager Connect allows for claims to be reconciled with the click of a button. This means that your practice will benefit from:

  • Improved debtor books
  • Dealing with only those amounts the patient still has to pay the practice
  • Time and money saved – the practice manager will no longer have to phone a call centre
  • More time for the practice to focus on the more important tasks in its business

More Information

For more information about this service, you can visit Discovery Health's website.