Frequently Asked Questions

  1. What is the primary function of EMSmca?

The basic function of EMSmcais to provide services to healthcare providers, in order for them to get paid by the Medical Aid Schemes, and to do the follow-up of unpaid accounts.

 

  1. Do you follow up on unpaid claims from Medical Aids?

Yes, after each pay run per medical scheme.

 

  1. What about my patient liability accounts?

On your individual instruction, we are happy to pursue patients that maybe liable to your practice for co-payments or non payments.

 

  1. How do I get my claims to EMSmca?
  • Via Email
  • Portal Submissions through your practice allocated portal on our Website.
  • Personal delivery to our offices
  • Collections can be arranged for volume submissions and on a one for one basis

 

  1. What is EDI?

EDI stands for Electronic data Interchange and it is the fastest and most reliable way to transmit data from one computer to another.

 

  1. How does the EMSmca system work?

Once we receive your documents, these are quality assessed and then data captured. Billing is then done in a separate department and your claim is then transmitted to the respective Scheme/Fund/Insurer for payment. Any claim rejected will be re-actioned immediately upon notification and all payments are effected directly into your account.

 

  1. How long do I have to wait to get reimbursed?

Claims are paid in accordance with each Medical Schemes payment turnaround times, however EMSmca strives to reduce delays in payments by ensuring timeous submissions coupled with the highest quality of claims.

  1. Do I receive any reports from you?

Claims summary’s are supplied monthly.

 

  1. How do you reconcile payments received?

Upon registration with us, we will change your  e-mail address at the medical aids to ours, in order to streamline the reconciliation process. All remittances received will be emailed to you.

 

  1. Do I have to sign a contract with you?

Yes, a standard service level agreement to protect both parties involved.

 

  1. Who has access to my data?

In compliance with the Protection of Personal Information (POPI) ACT, we will treat your data with the strictest of confidence and will never release data pertaining to any patient or practice unless requested to do so, in writing, by your practice.

 

  1. How secure is the data I give to you?

All data and files given to us is under strict control. We do daily back-ups of our complete system.

 

  1. Do you do new practice registrations?

Yes, we will register and update your banking details at all Medical Aids and relevant institutions.