MMSA currently
accepts claims in either paper or electronic form. However,
when submitting electronically the payment cycle is dramatically reduced. Another
benefit is that in most cases, your software supplier can provide the interface
to
Sovereign using your existing practice management software.
There are several options your software supplier has available to send claims
electronically to Sovereign:
 VANs (Value Added
Networks)
Claims
are delivered from you to Sovereign's mailbox which is emptied on a daily basis.
Contact one of the following vendors for further details:
Firstnet
Mailbox address: 6004930005825
Traffex
Mailbox
address: ZA010525.NATMED1
Helpdesk: 0800 117 888
You may also want to approach one of the so-called "clearing houses"
who collect
claims from several practices and then forward them to the appropriate
medical
schemes using a VAN.
Email -
Submission specification
Should the cost of the VAN option be too prohibitive, perhaps
email is the right
solution for you. All that is required is a modem and an
email account with one of the local ISPs (Internet Service Providers). Claims
are sent as an attachment in a pre-defined format (see below). All incoming emails
are fully audited and an
automated receipt is returned to your inbox.
At the moment these
facilities are provided by the following:
Mediswitch
Mediswitch currently provides pharmacies with facilities to submit ACUTE, CHRONIC
and PAT claims to MMSA. Development is currently underway to enable
general practitioners to submit all types of claims via Mediswitch.
Medikredit
Medikredit also provides pharmacies with facilities to submit ACUTE,
CHRONIC
and PAT claims. At the moment, Medikredit also allows for general practitioners
to submit ACUTE, CHRONIC and PAT claims. Development for the acceptance of all
general practitioner claims is pending.
HealthBridge
HealthBridge is currently in the final stages of testing. They will soon be providing
real-time claiming facilities to general practitioners. All types of claims will
be accepted.
Interpharm
Development is currently underway to accept ACUTE, CHRONIC and PAT claims via
Interpharm.
The format of submitted claims may be one of:
EDIFACT (MEDCLM)
The internationally recognised messaging standard and the preferred format.
Specification
Example
External claim file
format
Our own, internally developed format.
Specification
For more info email :
[email protected]
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