Knoweledge Base
V Prof Services is a SAMA Partner Medical Practice Administrator, Medical Bureau and Professional Accounting Firm
Q: Do I need to buy any new software from V-Prof with the system?
A: No, we use our own software, and does V-Prof carry the cost of installation thereof at the practice.
A: You also have the option of no software at the practice and V Prof handling all your claims on a daily basis.
Q: What about training on the new system?
A: Again, V Prof does the training at your practice at your convenience, at the cost of V-Prof.
Q: Do you do validations, to check if patients have funds available on their Medical Aid?
A: Yes, we do. Furthermore, our systems are designed to match remittances from medical aid companies on payment, to the claim number, enabling us to identify the amount the patient is liable for automatically. This drastically improves the collection process.
Q: How quickly do you start following up on amounts the patient is liable for?
A: Again, due to our electronic remittance and payment matching, the arrear amounts are calculated immediately and subsequently followed up with the patients.
Q: How do I submit claims to medical aid companies?
A: All claims are submitted on the Software V Prof installs at your practice to V-Prof automatically and every hour, where after they are perused by us to ensure diligent and proper submitting to the medical aid company involved. This minimises claim rejections due to incorrect information.
A: The option is also available for us to collect all the claims at your practice on a daily basis and capture the claims at V Prof and following up on them.
Q: How soon after I’ve signed the contract, does the medical aid company’s effect the changes?
A: We inform the medical aid companies of the changes, and are they effected within two weeks from contract signing. This ensures that no interruption in the practice cash flow is experienced throughout this time.
Q: How am I ensured that V-Prof can deliver on what is promised?
A: All contracts are on a three month trial basis. If the practice is not satisfied with the service received, V-Prof effects the changes back to where the practice needs it, without any cost. We cannot and will not bind you to a contract if you are not completely satisfied with our service. With any Professional company there is always the right way to do things via an agreement and you will appreciate the fact that the service agreement is to your benefit!
Q: What if the practice experiences IT difficulties at any time, so that no claims can be submitted to V-Prof?
A: We have standby IT specialists in the case that problems may be experienced. It is off course imperative that the practice maintains its own internet connection at all times if the first option is selected.
Q: What is the expected turnover time, from submitting a claim, to payment to the practice?
A: Depending on the medical aid company, payment times differ from 14 to 60 days, V-Prof however uses a diary system and you the Professional receive payments every 7 days, ensuring quick turnover times. This is of course also applicable to amounts patients are liable for.
Q: What about excess staff and stationary costs such as sending out letters to patients? V-Prof will cut the use of staff for these functions.
A: Correct, V-Prof supplies a service which in effect cuts staff costs, but will a dedicated staff member still be needed for the input of claims to the our software if this option is selected. Furthermore, V-Prof eliminates the need for variable costs towards running a practice or hospital, V Prof eliminates excessive staff costs, postage, letters, faxes, follow ups via telephone or emails, PMA costs and especially your time to do whatever you like. The purpose of V-Prof is to minimise practice input costs, and maximise effectiveness in claims processing, debtor management, financial and tax management, and to place the practitioner in a position to practice medicine, without the worries and costs involved in practice management.
Q: What do I do with cash payments on patient liable amounts at the practice?
A: Any cash received at the practice is not within our billing range, meaning, we do not charge the practice commission on these amounts. We only charge on what is collected in the “Collection Account”, opened on behalf of the practitioner.
Q: What about authorisations to medical aid companies, with regards to the blocking of funds on the medical aid of the specific patient?
A: V-Prof handles authorisations on behalf of the practice. A request is lodged with our clients department, and do we attend to them asap.
Q: What makes V-Prof different from other service providers in the industry?
A: Our primary difference is the fact that we are a professional service provider. No other bureau or service provider supplies the range of professional services we do on the basis that V Prof does it.
Ontime
Ontime or realtime communication, is a client initiated connection that sends a message over the internet to our hosted server.
eMD intern establish a connection with the Medical Insurance Provider and awaits a response. On completion, the response is then returned to the client for review. Our hosted webservice is secured using SSL using 128 bit encryption, our clients can be assured that all transmission are safe and secure. All claim/eligibility/sms messages are saved to an audit database for future reference.
- Web Services – Web services extend the World Wide Web infrastructure to provide the means for software to connect to other software applications. Applications access Web services via ubiquitous Web protocols and data formats such as HTTP, XML, and SOAP, with no need to worry about how each Web service is implemented. Web services combine the best aspects of component-based development and the Web, and are a cornerstone of the Microsoft .NET programming model.
- Secure Socket Layer – Web Server Certificates secure confidential information exchanged online and confirm your site’s identity to employees, business partners, and other users.
- Extensible Markup Language (XML) – Messages transmitted between client, eMD and Medical Insurance Providers make use of xml. Xml is simple to use over the internet and will support a wide variety of applications.
Batch Claims
If a claim does not have the ability to be processed via the Ontime server, or if you are running in offline ie. not connected to the internet; will be batch processed. Once eMD have received the latest claim through a replication, will be batched and sent to the relevant Medical Insurance Providers. Usually when a claim is batched, it is sent to the Medical Insurance Providers using various FTP protocols. Typically Medical Insurance Providers host an FTP, SFTP or FTPS server.
- FTP – Is a standard network protocol used to transfer files from one host to another host over a TCP-based network, such as the Internet.
- SFTP – SSH File Transfer Protocol, is not related to FTP except that it also transfers files and has a similar command set for users. SFTP, or secure FTP, is a program that uses Secure Shell (SSH) to transfer files.
- FTPS – FTP over SSH (not SFTP) refers to the practice of tunneling a normal FTP session over an SSH connection.
Reporting
MD runs a data warehouse, which stores data from each client database for reporting purposes. The reports are used in each of our administration processes, to measure performance.. The data-warehouse makes use of SQL database technology and reports may be generated and emailed using various formats like PDF, Excel etc.
- PostgreSQL – PostgreSQL is an object-relational database management system (ORDBMS). POSTGRES pioneered many concepts that only became available in some commercial database systems much later.
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