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What is EDI and claims switching?

Electronic Data Interchange (EDI) is computer-to-computer exchange of documents in an electronic format. Claims switching is essentially the electronic way of submitting medical aid claims to various medical aid administrators via an EDI supplier.

What is batch claiming?

It is the submission of a collection of different patient medical aid data/information submitted to the scheme in one bundle.

What is real-time claiming?

It is the submission of single patient medical aid data/information submitted to the scheme immediately; in actual real-time. Real-time claiming refers to the immediate and complete adjudication of a healthcare claim upon receipt by the medical aid. This feedback happens within seconds of submission.

Which switch product is right for my practice?

Depending on the type of practice and processes within your practice you will have a choice between batch or real-time claims submission. Visit our product page to see which product is right for your practice.

How does claims switching work?

MediSwitch validates claims on behalf of the medical aids according to the medical aid scheme rules. If the claim adheres to the MediSwitch upfront validation, it is sent through to the medical aid scheme administrator for processing.  If it does not adhere to the upfront validation, it is sent back to the practice with a rejection code.  This gives the practice the opportunity to correct the claim and resubmit it. MediSwitch does not charge practices for upfront rejections.

Customer Services

Contact Centre Assistance

If you require any assistance, always contact us on 010 449 1000. There are only four options to select from. At any point, during your call, you can select the relevant option without having to listen to all the voice prompts.

  • PRESS 1 New sales, products, and value-added services.
  • PRESS 2 Accounts Department (for any queries on your account with us).
  • PRESS 3 Credit card support related queries.
  • PRESS 4 For Practice management software support and claims queries.

What happens if I prefer to email?

Emails have been streamlined to one system and customer cases complete with customer history will be created for easy tracking. The below are the designated email addresses to be used:

What are the official business hours?

  • The credit card, sales, and finance teams are available during business hours on weekdays between 8 AM to 5 PM.
  • For your convenience, our software support team is there to help you between 7 am and 6 pm on weekdays and 8 am to 1 pm on Saturdays.

Does Altron HealthTech offer training?

  • Our comprehensive training programmes help your practice staff use our products optimally. We offer monthly virtual training courses to all our customers.We offer claims management workshops, receptionist training and practice management application training for all our customers. These are virtual training workshops and are charged at the following rates:
    • Claims Management workshop R350 (incl. VAT)
    • Medical Receptionist workshop R2000 (incl. VAT)
    • Practice Management training – TBA

    Training for PMA solutions is included in the registration fee you pay when you purchase any of our products and is valid for six months from the date of software installation.

    Please email Healthtech.training@altron.com to enquire about our training dates.

How long is the training?

    • Claims Management workshop: Full day
    • Medical Receptionist workshop: Full day
    • Practice Management training:
      • Elixir Live training: 2-day training session
      • Simplicity training: 1-day training session
      • MedeMass+ (ME+) training (available on request): 1-day training session
      • New HEALTHone sale: training is included in registration costs and conducted on-site
      • New Healthsoft sale: training is conducted via team viewer

Who do I contact for my invoices and statements?

You can request your invoices from our Administrative team by sending an email to: Healthtech.admin@altron.com. To ensure that you receive your statement and invoices timeously, please send your email address to Healthtech.accounts@altron.com.

Who do I contact for my invoices and statements?

You can request your invoices from our Administrative team by sending an email to: Healthtech.admin@altron.com. To ensure that you receive your statement and invoices timeously, please send your email address to Healthtech.accounts@altron.com.

How do I update my practice details?

Updating your details can be done in one of the following ways:

Send an email to healthtech.admin@altron.com.

If you are a MediSwitch user, login to WEBDesk and under the Profile menu button, click on Practice Details. Then proceed to update the editable fields you want changed.

How long does Altron HealthTech keep my transacted records?

MediSwitch is obligated to store and upon request, provide your practice with proof of delivery/submission for claims submitted during the last 12 months only.

How do I register to receive electronic Remittance Advices (eRAs)?

All you need to do is login to WEBDesk and fill in an eRA consent form. Select the scheme administrator(s) which you would like to receive eRAs from and complete the compulsory practice consent fields and submit.
Consent forms for the selected scheme administrators will automatically be generated and sent off – all done in one form! You will start receiving eRA’s as soon as the scheme administrators have activated this service for you.

What is the Daily Action Report?

The Daily Action Report is designed to assist your practice in dealing with any issues requiring attention from the previous day’s claim submissions. You have the option to receive the report in PDF or Excel.

 

The report is sent each morning, via email and contains the following tabs:

TAB NAME HOW TO USE THE INFORMATION
MediSwitch: This displays all claims rejected by MediSwitch’s upfront validation process. These rejections need to be corrected and resubmitted as soon as possible. Use the supplied Rejection code(s) and Description(s) column to fix the errors on the claim lines.
Scheme: This section indicates responses received from the medical aid schemes. The information will either contain rejections, errors or part-payments. Please note that this tab contains all rejections at scheme level. Always cross-check the dates of rejections to ensure that you don’t resubmit claims that you have already corrected. We recommend that you follow up with respect to part-payments to ensure uninterrupted cash flow to your practice.
eRA: This tab displays a summary of the electronic remittances received from the medical aid scheme administrators. Simplify and speed up your payment reconciliation processes by checking the total amounts paid by the scheme against your submitted claims. Remember to follow up on any co-payments as soon as possible.
eRA Detail: Contains detailed data of all the electronic Remittance Advices (eRAs) received from the various medical aid scheme administrators. These will either contain rejections, errors or part payments.