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.
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.
Claims Module
Our Claims Module streamlines the claims process, enabling efficient biometric verified and accurate submission and tracking. With automated claims adjudication and real-time status updates, our module reduces administrative burdens and improves user satisfaction, ensuring a seamless experience for healthcare service providers.
Member Module
Our Member Module offers real-time medical aid membership status and member validation to prevent fraud and ensure eligibility at the point of service. It enables seamless enrollment of member fingerprints and supports biometric verification during visits, ensuring that only valid, registered members access healthcare services. This secure, efficient system enhances trust between medical aids, service providers, and members by eliminating card sharing and improving claim accuracy.
The Switch is integrated with the following administration systems
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- 2Cana – HiP (various in ZW, ZM, NA)
- AfroCentric – Nexus (SA system for ZW client)
- HMS
- Prognosis
- Knowledge Objects
- Sirius Online
- Medicare
- Allois HIS