Our Solutions
Biometric Claims Switching
Biometric electronic switching platform allows service providers to send real-time electronic claims to Medical Aids using a biometric fingerprint reader for member verification and claims signing in Realtime.
Transaction Types*
- Biometric member enrollment and verification
- Member status and benefit confirmation
- Claims (Various integration options, depending on system capabilities)
- Member status confirmation
- Pre-Authorization
- Electronic remittance advice (ERA)
- 3rd Party system integration (Clinical claim washing/Managed Care)
- Business Intelligence (Data warehouse)
Our Core Modules*
Claims Washing
Our Claims Washing module ensures the accuracy and integrity of medical claims before submission. By detecting errors, inconsistencies, and potential fraud, we help healthcare providers and funders minimize claim rejections, reduce processing time, and improve overall efficiency in the reimbursement process.
Authorisation
The Authorisation module streamlines the pre-approval process for medical procedures and treatments. It enables real-time verification and approval of healthcare services, ensuring that patients receive timely care while reducing administrative delays and unnecessary costs.
Electronic Remittance Advice (ERA)
The ERA module provides a secure and automated system for processing payments and explanations of benefits. It allows healthcare providers to receive detailed electronic statements regarding claims payments, adjustments, and denials, enhancing transparency and simplifying financial reconciliation.
The Switch is integrated with the following administration systems
- 2Cana – HiP (various in ZW, ZM, NA)
- AfroCentric – Nexus (SA system for ZW client)
- HMS
- Prognosis
- Knowledge Objects
- Sirius Online
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