Medical Billing
Bureau Services
Running a busy medical practice shouldn't require managing an in-house billing department. NYMM's Medical Bureau takes over your entire billing cycle — from daily electronic claims submission and ERA reconciliation to proactive medical aid query resolution and respectful patient debt recovery — allowing your clinical staff to focus 100% on healthcare.
Direct EDI connectivity with all major South African medical schemes
Discovery Health
GEMS
Bonitas
Medscheme
Momentum Health
Bestmed
Fedhealth
Bankmed
Medihelp
CompCare
Fully outsourced billing and claims administration — our dedicated medical bureau team handles daily claims submission, medical aid follow-ups, ERA reconciliation, and patient credit control on your behalf.
Core Advantage
Engineered for South African Healthcare
We eliminate billing friction with direct scheme connectivity, HPCSA compliance, and clinical coding precision.
100% Scheme Coverage
Discovery Health, GEMS, Bonitas, Medscheme, Momentum, Bestmed, Fedhealth & more.
Rapid Cashflow Settlement
Daily EDI switching & proactive rejection resolution to compress your payment cycle.
Service Pillars
Key capabilities that power your practice
Detailed breakdown of how our bureau services service operates to protect your revenue.
Full-Cycle Outsourced Administration
Complete operational handover of your billing burden, eliminating staffing friction, holiday backlogs, and software overhead.
- Zero in-house billing team payroll overhead
- Dedicated senior account manager assigned to your practice
- Uninterrupted daily submission workflows year-round
Accredited Clinical Coding Review
Every claim is audited by experienced clinical coding specialists to ensure correct modifier usage, diagnostic pairing, and scheme compliance.
- Pre-submission code validation to stop rejections
- Discipline-specific coding rules (Anaesthetics, Surgery, Physio, GP, etc.)
- HPCSA tariff guide alignment
Proactive Medical Scheme Follow-Up
We maintain continuous follow-up with medical schemes on pending, held, or queried claims, securing prompt payment turnarounds.
- Immediate tracking of unpaid or disputed lines
- Direct liaison with scheme claim assessors
- Elimination of stale claims approaching 120-day cutoff
Respectful Patient Credit Control
Ethical and professional communication with patients regarding co-payments, shortfall balances, and electronic statements.
- Automated electronic statements sent via SMS and email
- Courteous telephonic follow-ups for outstanding co-payments
- Flexible payment arrangement tracking and receipting
What we deliver
- Complete outsourced billing lifecycle — from claim preparation to final payment
- Daily electronic claim submissions via secure direct EDI medical scheme links
- Dedicated clinical coding specialists reviewing submissions before release
- Rigorous medical aid query follow-up to eliminate unpaid or delayed claims
- Electronic Remittance Advice (ERA) processing and automatic bank reconciliation
- Respectful patient debt collection and digital statement distribution
- Liaison with medical schemes on disputed, rejected, or delayed claims
- Comprehensive monthly practice performance reports and revenue reviews
Business outcomes
- Eliminate billing staff recruitment costs, leave cover, and training headaches
- Improve monthly cash flow through daily submissions and prompt scheme follow-ups
- Significantly reduce bad debt with structured patient credit control workflows
- Gain 100% financial clarity with transparent monthly management reports
- Scale your practice patient volume seamlessly without adding administrative staff
Step-by-Step Workflow
How our process works for your practice
Transparent, systematic, and aligned with statutory Medical Schemes Act guidelines.
Daily Practice Charge Log Handover
Your reception or clinical staff sends daily charge sheets or patient logs electronically through our secure portal.
Clinical Coding & Quality Audit
Our certified billing team audits diagnostic codes, procedure tariffs, and modifiers to ensure 100% compliance.
Electronic Submission & Tracking
Claims are switched directly to medical schemes via EDI with automated submission acknowledgements.
Remittance Matching & Patient Statements
ERAs are processed and matched against bank deposits. Any co-payments or shortfalls are billed to patients promptly.
Executive Month-End Review
You receive a comprehensive monthly financial pack detailing billed revenue, collected cash, outstanding age analysis, and scheme trends.
Frequently Asked Questions
Answers to common practice queries
What is the difference between software-only and your bureau service?
With software-only, your internal staff enters data and follows up on claims. With our Bureau Service, our experienced team manages the entire administrative cycle — coding review, submission, medical scheme follow-ups, ERA reconciliation, and patient payment collection.
How quickly are claims submitted to medical aids?
Claims are submitted electronically daily. We do not wait for monthly batch cycles, ensuring steady weekly cashflow into your practice bank account.
Does your bureau service cover practices outside major cities?
Yes, NYMM operates nationwide with offices in Johannesburg and Bloemfontein, supporting healthcare practitioners across all 9 provinces in South Africa.
Explore More
Other specialised billing pillars
Practice Management
More than an admin tool — a complete clinical and practice management system that handles appointments, electronic health records, real-time medical aid eligibility verification, and ICD-10 diagnostic coding across all major South African medical schemes.
Medical Billing Solutions
High-performance claims management, direct EDI switching, PMB (Prescribed Minimum Benefits) motivations across 270 conditions, and automated rejection turnaround pipelines.
Reporting & Analytics
Comprehensive financial intelligence — including Electronic Remittance Advice (ERA) bank reconciliation, 30/60/90/120+ day debtor age analysis, and accountant-ready revenue packs.
Medical billing enquiry
Let's talk about bureau services for your practice
Tell us about your practice — size, disciplines, and how billing is handled today — and our billing team will recommend the right fit.