Guides
Getting paid by South African medical schemes
Practical guides for people who run a practice: why claims get rejected and how to fix them, what every line on a remittance advice means, what billing actually costs, and how to keep scheme admin from eating your week. Written from what we see in real claim traffic, not from a brochure.
If you are weighing up software, the short answer on cost is R9.50 a claim with the first 10 each month free.
Start here, by problem
- Claims are coming back rejected. Why medical aid claims get rejected covers the common reasons and the same-day fix for each.
- The money does not match the claim. How to read a remittance advice walks a real statement line by line.
- Payment is taking too long. Real-time versus batch submission shows where the delay actually sits.
- Billing is costing too much. What medical billing costs in South Africa compares commission, in-house staff and per-claim software.
- You have changed bank accounts. How to change practice banking details with every scheme, without losing payouts.
7 September 2026
How Long Do Medical Schemes Take to Pay - and How to Get Paid Faster
Scheme payment runs, the 30-day rule, the four-month stale-claim window - what actually determines how fast your practice gets paid, and the three levers that speed it up.
24 August 2026
How to Start a Private Practice in South Africa - and Get Paid From Day One
The practical checklist for starting a private healthcare practice in South Africa: council registration, your PCNS practice number, medical scheme setup, and billing that pays from the first claim.
21 August 2026
Is There Free Medical Billing Software in South Africa?
An honest answer on free medical billing software in South Africa: what free usually means, why claim submission costs money, and what to check first.
21 August 2026
How to Choose Medical Billing Software in South Africa
Six things to check before choosing medical billing software in South Africa, the questions to ask on a demo, and when a billing bureau is the better answer.
21 August 2026
How to Switch Practice Management Software Without Losing Money
Sequencing a move to new practice management software without losing claims or balances: what to export, when to cut over, and what cannot come with you.
10 August 2026
How to Read a Medical-Aid Remittance Advice
Claimed, approved, paid, patient portion, reason codes - what every line on a South African medical-scheme remittance advice means, and how to spot the money you're leaving behind.
27 July 2026
Real-Time Claim Submission vs Batch: What It Means for Your Cash Flow
Batch submission delays every rejection by days and can cost your practice a full payment run. The cash-flow maths of real-time claims for South African practices.
13 July 2026
What Does Medical Billing Cost a South African Practice?
The three ways SA practices pay for billing - percentage commission, in-house staff, and flat per-claim software - with the real-cost maths and how to pay less without losing control.
28 June 2026
Why Medical-Aid Claims Get Rejected - and How to Fix the Top Reasons
The most common reasons South African medical-aid claims get rejected - and how real-time submission lets your practice catch and fix them the same day.
14 June 2026
How to Change Your Practice's Banking Details With Every Medical Scheme
Update your banking details with every South African scheme from one form, without losing payouts.
21 August 2026
Where the Admin Hours Actually Go in a Private Practice
The real administrative time sinks in a South African private practice, which of them are avoidable, and which are structural no matter what software you run.