Pharmaceutical and Consumable Rates
These data files ensures that you are using up to date NAPPI codes, and applying the correct mark-up as specified by each medical aid. This decreases the rejection of claims, and saves you time and hassle of doing manual adjustments due to short payments.
Additional dispensing rules and remarks will notify you when a medical aid only covers 80% of the consultation fee, when a dispensing levy applies, or when the patient will only be reimbursed if seeing a designated service provider. You will also be notified when a product is excluded for payment by medical aid.
This also takes the hassle out of trying to keep your Nappi codes and consumable prices up to date by capturing it from a wholesaler’s invoice. Often wholesalers sell products at a price higher than cost. This creates a scenario where you lose out on profit because you submitted the wholesale price instead of the original cost.
Medical Scheme Data
Keep your database of valid medical aids, options, plans and administrators updated, as well as the associated medical aid codes required for switching to the correct destination. It keeps you up to date with the latest changes due to medical aids being discontinued, amalgamating with others or changing administrators.
Our practice management system requires the correct scheme name and scheme codes at all times to ensure data integrity when electronic invoices are sent via the switch to the medical aid. This update will not just keep your medical aid codes up to date, but also your EDI or switching codes. You will no longer have to do laborious manual updates.
For a complete list of medical aid administrators we switch to, view our @Html.ActionLink("Supported Medical Aids", "medicalaid", "service") page.