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Medical Billing Software Invaluable to Private Practices in South Africa

For those who receive their paycheque from a private hospital group each month, the administrative responsibilities they must deal with may be a burden, but at least their salaries do not depend upon its accurate and timely completion. For those who have chosen to operate a private practice, the story can be a very different one, in which incomes are totally dependent upon the accurate and timely completion of certain administrative tasks. The medical billing function, with or without the aid of specialised software, is crucial to the continued operation of private practices in South Africa and wherever GPs, dentists, and other healthcare specialists practise outside of a state health service.

Payment for services received, whether for consultation, surgery, some other form of treatment, or for prescribed medications, in all but a small percentage of cases, are subsidised by one of the nation’s medical aid funds. The latter set the various maximum amounts that they are willing to pay for everything from sutures and disposable syringes to CT scans and cardiac catheterisation. These limits may, in some cases, amount to a full reimbursement of the cost, while in others, the limit set for reimbursement may be less than the actual cost, leaving the patient to make good the shortfall by means of a co-payment. Accurate claims are therefore crucial, and this works best when medical billing is assisted by software compatible with the various claims procedures operating in South Africa.

Time constraints can often make it difficult to devote all the attention required to ensure that the claims process runs as smoothly as it should. In practice, it is believed that, between them, GPs and specialists in private practices lose millions of rands in unpaid claims every year due to late submissions, omissions, and various avoidable mistakes that lead to claims being declined. With the use of a suitable medical billing software package configured for use in South Africa, all the difficulties that result in these costly losses of revenue could be eliminated,

At least as important as safeguarding the existing revenue stream, however, is the benefit of the time saved that also follows when deciding to automate the claims function. That additional hour or more each day that might otherwise have been devoted to this task can be reduced to mere minutes, allowing more time to pursue the core business of a physician – attending to patients. As well as improving the image of the practice, the one or two additional appointments per day that, if delayed for lack of a vacant slot might have been lost to another practice, can now be retained, further bolstering its income. Of course, the medical billing task could be allocated to a practice manager rather than to a software package. Unfortunately, in South Africa and everywhere else, all employees require managing. They also need time off for holidays and illness, and their salaries can add substantially to the existing overheads.

Some private practitioners argue that the cost of computerising this crucial function would not really justify the transition. Given the initial outlay to purchase the package, perhaps a requirement to buy additional hardware, to upgrade existing machines, and the possible need to hire an IT specialist to handle the installation and ongoing maintenance, the argument could be seen as a valid one. In practice, however, it is now possible for private practitioners in South Africa to avoid all these additional costs when updating the task of medical billing to a software-based solution. The savings are made possible through a technology known as SaaS or “Software as a Service”.

In a SaaS solution, the package is not purchased and all responsibility for updating and maintenance, such as data storage, backups, program updates, and disaster recovery rest with the service provider. End users access the various functions via an Internet browser, using a thin client to connect securely to the application software hosted on the service provider’s server. With no capital outlay, the modest monthly fee makes medical billing software a very affordable option for private practitioners in South Africa.

V Professional Services, a Pretoria-based SAMA Partner Medical Practice Administrator, Medical Bureau and Professional Accounting firm offers a range of administrative functions though comprehensive client-server applications developed to assist doctors and other healthcare professionals who operate private practices. Among those applications, the company’s web-based medical billing software is now assisting many private practices in South Africa.

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