Practice Services
Providing support, knowledge and technology to ensure a thriving healthcare practice
With growing complexity, payment ambiguity, managed care, co-pays and other healthcare insurance trends, the SpesNet products and services have been designed to help professional medical healthcare practitioners and their practice staff to effectively manage the operational and business aspects of their practice by providing practical solutions for "real-world" concerns in everyday practice.
These include:
Health Code Index
Accurate coding reduces administration, the need for motivations and medical scheme rejections. We provide you with a clinically appropriate cross match between RPL, ICD-10 and CPT4 (CCSA) codes and also:
- An RPL, ICD-10 and CPT4 search engine
- RPL tariff, including Payment Arrangements tariffs
- PMB indicator per ICD-10 code
- ICD-10 Age and Gender validation
- Primary & Secondary ICD-10 code validation
- ICD-10 External Cause code warning
- NAPPI code search
- Real-time coding updates
Funder's File
A central repository of all Medical Scheme’s plans, benefits, co-payments and limits. Know exactly what cover your patients have before treatment.
Website Builder
Ensure you have an online presence! That’s how patients find you. You are now able to build and manage your own website – free to subscribing members.
Payment Arrangement Database
A central repository of all Medical Scheme’s Payment Arrangements and Alternative Reimbursement Models (ARM’s). Optimising your practice income by assisting you in comparing these and choosing the correct ones for your practice.
Healthcare Helpline
This call centre is both managed and supported by a dedicated team of medical professionals, clinical nursing case managers as well as coding experts. Call them for advice on ICD-10, RPL and CPT4 (CCSA) coding, PMBs and general healthcare issues.
Human Resource Management and Legal assistance
As a subscriber we provide you with electronic contracts and policy documents, saving you time and assisting you to manage your staff and protect your practice. We also provide you with other legislated forms and documents such as a Practice Patient agreement, the Childrens Act forms and National Health Act to name a few.
Let us deal with the Medical Scheme red tape – we will handle your Medical Scheme escalations relating to outstanding and short payments as well as PMB claims.
Injury on Duty Claims
Let our dedicated team of specialists assist you in recovering your outstanding IOD claims. Let us deal with the red tape at the Compensation Fund.
Accurate coding reduces administration, the need for motivations and medical scheme rejections. We provide you with a clinically appropriate cross match between RPL, ICD-10 and CPT4 (CCSA) codes and also:
- An RPL, ICD-10 and CPT4 search engine
- RPL tariff, including Payment Arrangement tariffs
- PMB indicator per ICD-10 code
- ICD-10 Age and Gender validation
- Primary/secondary ICD-10 code validation
- ICD-10 External Cause code warning
- NAPPI code search
- Real-time coding updates
A central repository of all Medical Scheme’s plans, benefits, co-payments and limits. Know exactly what cover your patients have before treatment.
This call centre is both managed and supported by a dedicated team of medical professionals, clinical nursing case managers as well as coding experts. Call them for advice on ICD-10, RPL and CPT4 coding, PMB’s and general healthcare issues.
With established relationships at all the major Funders we are able to provide services that include:
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Medical coding support and assistance including
- ICD-10 diagnostic codes,
- NHRPL (SAMA) codes,
- CPT4 (CCSA)
- Combinations/cross matching of these code sets
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Advice on correct application of RPL rules and modifiers
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Coding assistance and support with clinically complex cases.
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Account intervention and assistance with Funder escalations, Prescribed Minimum Benefits (PMB) accounts and PMB Pre-authorisations.
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Regular electronic updates about changes in billing rules and coding standards.
As a subscriber we provide you with electronic employment contracts and policy documents, saving you time and assisting you to manage your staff and protect your practice.
We also provide you with other legislated forms and documents such as a Practice Patient contract, the Childrens Act forms and National Health Act to name a view.
We have negotiated with all major Banks to offer you exceptional discounts on transactional and rental fees on in-room credit and debit card machines. The savings you generate out of this service, often makes the SpesNet membership offer more than cost-neutral. Use our online Savings Calculator to see how much you could save.
Let our dedicated team of specialists assist you in recovering your outstanding IOD claims. Let us deal with the red tape at the Compensation Fund.
SpesNet offers training through DUXAH, The Academy of Healthcare. DUXAH, evolved from within SpesNet and embarked on a mission to educate, motivate and incentivise postgraduate training and assist Specialists, their staff and all healthcare administration managers.
We offer the following:
Coding training
- ICD-10 coding
- RPL coding (Reference Price List)
Prescribed Minimum Benefits (PMB) training
Healthcare Professional Development Programme
- Practice made perfect
- Research Methods
- Risk Management
- Statistics for clinicians
Healthcare Management Certificates (HAMC)
- Administration Management Certificate
- Healthcare Management Certificate
- Business Management Certificate
For more information about our training services, please visit the DUXAH website – http://www.duxah.co.za
Use this tool to search for the correct NAPPI code based on the product name, product code and manufacturer detail.
Through Health Code Index we provide you with a Prescribed Minimum Benefit (PMB) indicator on ICD-10 codes and our Healthcare Helpline is just a call a way to assist you with your outstanding and short paid PMB claims.
Use the SMS Communicator as your preferred SMS service provider to communicate appointments and outstanding accounts – at extremely competitive rates.