Medical Service Providers

Services

Medical Service Providers

  • We scrutinise all accounts received and ensure that billing and documentation are according to the Gazetted rules.
  • We assist as far as possible with claim registration and adjudication.
  • Contractually we agree to effect Pre-fund payments within 10 working days from the date that accounts are accepted by CompSol, provided that there is a valid CompEasy claim number, and all supporting documentation, as prescribed in the Government Gazette, is in order and duly submitted to CompSol.
  • CompSol will prefund accounts irrespective of the Compensation Funds (CF) claim status i.e., CompSol will prefund an account even before the CF has accepted liability for the claim.
  • Many employers are not complying with the requirements of the COID Act in terms of submitting the prescribed documents when registering a claim, resulting in non-adjudication of claims for extended periods.
  • CompSol has a dedicated task team whose primary focus is to contact employers for claim numbers, or to assist them should they struggle to register a new claim on CompEasy.
  • Where claim related documents are outstanding, the task team will also attempt to assist employers to either upload the documents on CompEasy, or request the documents to be supplied to CompSol for submission to the CF obo the Employer, should they be comfortable to supply same to CompSol.
  • It is important that all registered claims are timeously adjudicated by the CF to ensure the accounts related to these claims can be submitted to the CF for payment. CompSol has ongoing projects with the Department of Labour offices of each province, as well as regular follow-up meetings with the CF adjudication team, and regular Operational meetings with CF HQ, to assist with the claim adjudication process where possible.
  • Once liability of the claim is accepted, CompSol will do a final quality check and then switch the electronic account information to the CF for payment.
  • CS has a dedicated team focussed on uploading all the required medical reports on CompEasy prior to switching the invoices for payment.
  • Once the accounts have been processed through our system and accepted, they are switched to the CF for payment.
  • CompSol manages the entire process and delivers an end-to-end solution. We utilise our ±400 specialised IOD staff to manage all the various aspects of the IOD value chain.
  • We have well trained Client Service Officers (CSO) in your area, and they will assist with the following:
    • They provide ongoing training (adhoc and annual rule changes in Government Gazette, workflow changes in eCOIDA to adapt to CF system related changes, refresher training etc) to hospital staff and contracted SP’s within the hospital.
    • Assisting with claim compiling / completion.
    • Liaison between your practice and CompSol admin staff.
  • CompSol follow up with Employers and endeavour to obtain required documentation from them (W.Cl.2, I.D., etc.) as and when required.
  • We contact Employers to correct errors on documentation if and when required
  • eCOIDA is a CompSol in house developed, integrated paperless IOD management solution linking Employers and the Medical Service Providers in real-time on the same database / platform, seamlessly via Web portals.
  • The offering includes IOD case management and workflow functionality.
  • Your practice will be able to make use of the full eCOIDA system at no additional cost.
  • Medical Service Providers in our Network that make us of our eCOIDA system can share supporting documents to you.
  • Our eCOIDA system offers you monthly reports.
  • The functionality to access our website (24/7/365) to enquire regarding
    • the status of your account submissions (batches)
    • current batch being processed
    • detail pre-fund payment advices can be downloaded
    • statutory documents and yearly new Tariff schedules
  • Practice Management reports prepared and provided to the practice indicating progress on status of claims on age, sales trends, etc.