Money in motion

Billing + Claims

Real-time scheme reconciliation · aged debtors · pre-flight rules engine for SA medical aids
MTD revenue
$27k
+18% vs LM
Cash collected
$23k
85% of charged
Claims pending
11
$1,380 in flight
Avg payout days
12.4
Industry 18-21
Rejection rate
3.2%
Target <5%
Aged debtors · live
$2,140 over 30d
Patient / Scheme
0-30d
30-60d
60-90d
90+d
Total
GEMS Onyx
3,450
2,180
0
0
5,630
Discovery KeyCare Plus
8,200
1,050
0
0
9,250
Bonitas Standard
2,150
850
0
0
3,000
Sarah Klein · cash co-pay
430
0
0
0
430
Anders Mokoena · short-pay
0
1,200
0
0
1,200
Tom Kruger · cash
950
0
0
0
950
Imogen Davies · cash
2,400
0
0
0
2,400
Pieter Niemand · cash
0
0
3,200
5,400
8,600
Total
17,580
5,280
3,200
5,400
$1,750
Scheme payout times · last 90d
Days from submission to scheme payment
Discovery is fastest at 8.2 days. GEMS slowest at 16.4 days. The pre-flight engine catches 94% of would-be rejections before submission — saving the average claim 7 days of resubmission cycle.

Claims pipeline · all schemes

All · 47
Pending · 11
Short paid · 5
Rejected · 2
Paid · 29
PatientVisitSchemeICD/TariffAmountStatusAction

Pre-flight engine · last 30d

SA scheme rules + ICD/tariff congruence + benefit checks
Caught before submission
147
Missing modifier · ICD/tariff mismatch · benefit exhausted · pre-auth needed · code outside discipline
Estimated rework saved
23 hours
Avg 9 minutes per rejected claim · billing clerk hours that would otherwise reprocess fail/resubmit
Avg first-pass acceptance
96.8%
Industry baseline 84% · Healthbridge benchmark 92%