Electronic claims & remittances
Medical aid claims, answered in real time
MedHQ submits your claims electronically to the popular South African medical aid schemes and shows you the scheme's answer while the patient is still in the room. When the remittance arrives, it's matched back to your invoices automatically.
Electronic switching included · No extra switching fees from us
The life of a claim, without the chasing
Most practices only find out what a scheme thinks of a claim when the statement arrives. MedHQ closes that loop — every claim is answered, followed up and reconciled in one place.
The invoice is coded and priced
ICD-10, tariff and NAPPI codes at the scheme's own rates, pulled from live tariff data — so the claim is right before it leaves.
Submitted electronically
The claim goes straight to the scheme — no portals, no batch files, no faxing statements at month end.
The scheme answers in real time
Accepted, short-paid or rejected — you see the response and the reasons immediately, while there's still time to act.
Remittances match themselves
Electronic remittance advices are imported and matched to your invoices automatically — every payment lands against the right claim.
The member portion gets collected
Whatever the scheme doesn't pay is flagged as member liability, and the patient gets a payment link on WhatsApp — not a paper statement.
Built for how schemes actually behave
Real-world claiming is messy — rejections, short payments, member liability, benefits that ran out in March. MedHQ is built for that mess.
Membership checked before the visit
Medical aid details are verified up front, so you find out about lapsed cover before the consultation — not after.
Rejections tracked with reasons
Every rejection and short payment is captured with the scheme's reason codes, queued for review, and resubmitted from the same screen.
Member liability made explicit
When a scheme pays short because it's the member's responsibility, MedHQ says so — and helps you collect it from the patient.
Remittance advices imported
Electronic remittances flow in and reconcile automatically — no more capturing payments off PDF statements line by line.
Surgery & assistant claims
Theatre procedures, assistants and modifiers are claimed correctly — the hard cases most systems get wrong.
Nothing slips through
Outstanding claims and unpaid balances are tracked until they're resolved — you always know exactly what's still owed, and by whom.
Pricing
of the payments you collect. Nothing else.
No monthly subscription, no per-user licences, no lock-in contract. Every feature — scheduling, AI scribe, billing, claims, WhatsApp and reports — is included, and nothing is charged on invoices that never get paid.
Frequently asked questions
Can't find what you're looking for? Get in touch.
MedHQ submits claims electronically to the popular South African medical aid schemes — and shows you each scheme's response in real time. If you'd like to confirm coverage for the schemes your patients use most, get in touch and we'll walk you through it.
For electronically switched claims, the scheme's adjudication typically comes back in seconds — while the patient is still with you. That means coding problems, lapsed memberships and benefit issues get fixed on the spot instead of surfacing on next month's statement.
The response is captured against the claim with the scheme's reason codes. Rejections queue for review so you can correct and resubmit from the same screen, and amounts that are genuinely the member's responsibility are flagged for collection from the patient.
Not from us. Claim submission, responses and remittance reconciliation are all included in MedHQ's single 3% (ex VAT) platform rate — there's no separate per-claim or switching fee from MedHQ.
Stop finding out on the statement
Submit your claims electronically and see the scheme's answer in real time. One rate — 3% ex VAT of what you collect — switching included.