How we work

Once the doctor discharged the patient he/she will provide reception with a billing sheet which provide the billing codes and ICD10 codes to ensure correct billing.

Reception will do billing on ELLE Health application which is a web-based practice management system, All medical aid claims are sent live and directly from the practice to medical aids via ELLE.

Reception will receive almost immediate claims response from each medical aid once claims have been received successfully by medical aids.

Based on the claims response from the medical aids reception will know if the claim is covered by medical aid or if the patient needs to settle.

For private patients what gets billed needs to be settled before leaving the unit.

As for international insurance claims – these are not submitted live, the patient has to notify their insurance that they are about to receive treatment and based on that the insurance then will send reception a Guarantee of Payment (GOP) which then allows the patient treatment and we then send the claim to the insurance manually for payment.