Medical aid billing

Claims answered
before they leave

Check a patient's cover before the visit, send the claim to MediKredit from the appointment, and see what the scheme pays and what the patient owes as soon as the response comes back.

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Fewer rejections, less chasing.

Most rejections start at the front desk: a wrong dependant code, a lapsed option, a missing diagnosis. Saya catches them before the claim goes out.

Check cover before the patient sits down

Run an eligibility check on the member number. A family check lists every dependant with their code, so the right person is billed.

Codes from the visit, not from memory

Tariff codes, ICD-10 diagnoses, NAPPI medicines and modifiers go onto the claim from the appointment, priced from Medprax tariff data.

The scheme's answer on the claim

Approved amount, what came from savings and what the patient owes come straight back onto the claim. A rejection shows the reason, so you fix it and resubmit.

Remittances that reconcile themselves

Import the electronic remittance advice and payments match to their claims. Anything that doesn't add up lands on a short discrepancy list.

One account per patient, from claim to statement

Claims, invoices, payments and the patient's portion sit on the same account. Send a statement for any period, or run them for every patient at month end.

How it works

What happens inside Saya, from the first click to the patient record.

01
Bill from the appointment
Open a finished appointment and the claim starts with the patient, scheme and date of service filled in. Visits nobody has billed stay on a list until someone does.
02
Procedures and medicines split for you
A claim with both procedures and medicines goes to the switch as the transactions it expects, and comes back to you as one result.
03
Reverse a claim without phoning
Billed the wrong code? Reverse the claim from Saya. If the reversal is refused, the claim keeps its last valid status instead of going missing.
04
Duplicates caught, not paid twice
If a claim has already been submitted, Saya says so and points you to the original instead of sending it again.