Medical aid switching firm Healthbridge has partnered with Digital Archiving Systems (DAS) to establish an electronic medical aid claims bureau that they say will see the healthcare industry save up to R237 million a year.
Healthbridge links together role players in the South African healthcare industry by facilitating claims processing for about 8 000 medical practices and administrators.
The electronic medical aid bureau, which is being set up by DAS, converts paper-based claims from medical practitioners into digital format, says DAS MD Ronald Melmed.
The platform uses character recognition software that reads paper-based claims that have been scanned into the system. The claims are then archived and made accessible to medical aid companies for the payment of claims.
Healthbridge account manager Paul Kent says a pilot is already under way with one of the leading managed care companies. The bureau could be up and running by the end of the year, he adds.
"We've tested the waters and administrators are very excited about what digital processing can do for their businesses. We've seen a strong interest and commitment from smaller administrators."
Speeding up
Melmed says the new system scans documents at a rate of about 1 000 claims a day, and "switches" the information in real-time, allowing faster processing and claim payments to consumers.
While over 80% of medical claims processing takes place electronically, many doctors and health providers are still pushing paper, he notes.
Turning paper into electronic data in the medical industry has historically meant employing individuals to painstakingly key in line after line of patient information, Melmed adds.
The new system, he explains, cuts the cost of processing paper-based claims from R20 to R5 per claim. The faster processing could lead to reduced medical aid premiums.
Healthbridge CEO Gerrie van Zyl says small administrators cannot hope to buy and implement the software themselves. "It would cost millions and take up to two years to train people to use it."
The partnership with DAS means there are no initial costs to small medical aid administrators, he says.
Van Zyl also predicts the savings administrators will realise will have a knock-on impact on the consumer. "It's such a competitive market that these savings will inevitably translate to lower premiums. It's going to give the pricing edge to many administrators and bring down costs across the spectrum."
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