Provider Solutions

DATA DRIVEN SOLUTIONS FOR HEALTH CARE PROVIDERS

Medprax provides access to a comprehensive Medical Scheme, Pharmaceutical and Tariff database that includes essential data for accurate coding, billing and error-free claim submissions. This speeds up the scheme adjudication and payment processes.

Healthcare

  • Extensive medicine, consumable and surgical device price files
  • Incorporating scheme-specific mark-ups
  • Comprehensive IH and OH rates
  • Day clinic rates
  • Specialist Consultation and Procedure Rates
  • GP network rates
  • Health Risk Assessment (HRA Rates)

Electronic Claims Switching

  • Up-to-date Medical Schemes Masterfile
  • Comprehensive tariff rates, ICD-10 codes and NAPPI codes
  • Fully integrated with all major switching platforms

e-Scripting

  • Single Exit Pricing (SEP) for all acute and chronic medicines
  • Identification of generic and therapeutic equivalents
  • Default dosage instructions
  • Active ingredient details
  • Allergy Indicator(s)
  • Drug classifications
  • Scheme exclusion criteria
  • Access to the Medprax Script Validation Tool
  • PBM (Pharmacy Benefit Management) feedback loops

e-Health Records

  • Supports back-end Clinical data record keeping
  • Adheres to Industry Standard data coding structures
  • Medical Scheme options and plans
  • Procedure codes
  • Nappi Codes linked to ICD-10 codes
  • Formulary per Scheme
  • Allergy flag linked to specific products and active ingredients
  • Drug-to-Drug and Drug-to-Disease integrations

By leveraging our pharmaceutical product and price file, healthcare practitioners can streamline medication management, enhance billing accuracy and optimise patient care delivery.

WHAT MEDPRAX DOES FOR YOUR PRACTICE

Brings a whole Industry’s worth of data to your fingertips

Covers every Scheme option of every patient who walks through your door

Core to accurate coding, billing and error free claim submissions

Essential data saves your practice time, money and resources

Accurate claim submissions speed up Scheme adjudication and payment processes

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Innovative Billing

To meet the ever-evolving needs of Healthcare practices, PMAs have streamlined their integrations to ensure seamless access to the Medprax Data.

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Complete Solution

Medprax is part of the automated data loop that connects patients to providers and funders by linking schemes to tariff rates, NAPPI codes and ICD-10 codes. This transforms a complex problem into a simplified data solution.

For a minimal monthly licence fee, the Medprax data files are seamless, accessed via the Medprax API which is integrated into all leading PMA’s.