Medical Aid benefits and exclusions are complex to understand and navigate. Most members of medical aids experience, at one time or another, frustration, confusion, or anger when their medical aid denies and/or short pays a claim for medical care. The byzantine rules, regulations, and procedures required by medical aids need detailed knowledge (both clinical and of the medical aid regulatory environment) on the part of the member to deal with problems and get these resolved.
These members often turn to their brokers for help. Most brokers do not have the capacity to carry this level of detailed clinical and regulatory knowledge and themselves get frustrated at the time and energy needed to resolve medical aid problems.
Med ClaimAssist is a team of caring claims experts who take all this hassle out of brokers’ and members’ lives and handle of the queries efficiently, quickly, and accurately on behalf of members and patients. Backed by detailed industry systems and databases the team is able to identify where the problem lies and intervene to solve it.
Whether the problem is coding errors on the doctor’s account, or processing errors by the medical aid – Med ClaimAssist identifies the issue and intervenes to solve it.
VAP clients of Med ClaimAssist have, for a small monthly fee, access to the full might and knowledge of the Med ClaimAssist team to stand behind them when they need help. Logging a request for help through the personal login of VAP clients at the Med ClaimAssist website (or via the websites or apps of our partners) results in the request being assigned to one of our Claims Specialists. The VAP client is given the direct contact details of the Claims Specialist and can track, in real-time, exactly what is being done on their query. The claims specialist interacts with the member, doctor, and medical aid to get the best possible outcome for the member.
There is no limit to the number of queries a member can log over time (there is a limit to one query at a time though).
Med ClaimAssist takes the heat and tension out of resolving medical aid problems in a transparent and caring way for our clients.