Claims & revenue recovery
Work the claims that have gone quiet.
Rejected and short-paid claims are rarely abandoned deliberately. They are left because nobody in the practice has uninterrupted time to work them, and they age until somebody writes them off. This can contribute to avoidable revenue leakage when administrative issues, outstanding queries and follow-up are not resolved.
You will recognise some of these.
- Your age analysis keeps growing and nothing is being actively worked
- Remittances arrive, get filed, and the short-payments are never read line by line
- Rejections are noticed but never corrected and re-submitted
- Reception spends mornings on hold instead of with patients
What this covers
The work itself
Reading the remittances
Going through remittance advice line by line against what was billed, so under-payments become visible instead of staying buried.
Working the rejection reasons
Establishing why a claim was rejected, correcting what can be corrected, and re-submitting where re-submission is appropriate.
Clearing the backlog methodically
Rejected, short-paid and ageing claims are worked systematically according to priority and status.
Follow-up that is diarised
Chasing outstanding queries on a set cadence, with a reference, a date and a named contact recorded for each one.
Reporting you can act on
Written feedback showing what moved, what is still outstanding, and what needs a clinical decision from you.
The shape of the problem
The scale a practice manager reads every month. The longer a claim stays unresolved, the more work it takes to move — and the fewer administrative options remain.
How a claim ages
Days outstanding- 0SubmittedClaim goes to the scheme
- 30UnpaidNo remittance yet
- 60Short-paidPaid under, reason unread
- 90AgeingNobody has the hours
- 120+ daysRisk of write-offFewer administrative options remain
HealthAdmin focuses on unresolved claims while there may still be an administrative pathway to correction, follow-up or appropriate escalation.
The record
Every query carries five things
Unresolved revenue can disappear into silence when queries are not systematically tracked, followed up or escalated. A query with no reference and no date is a query nobody can defend, chase or escalate. This is the minimum record HealthAdmin keeps on every one.
Reference
The scheme's own reference for the query, captured at the moment it is raised.
Date logged
When it went in, so the age of the query is a fact rather than a recollection.
Contact
Who at the scheme it was raised with, by name where the scheme gives one.
Outcome
What the scheme said, recorded in the words they used.
Next action
What happens next and when, so nothing closes by being forgotten.
Where this stops
HealthAdmin is not a debt collector and does not act against patients. This is administrative work with medical schemes and their administrators on your practice's instruction. Whether a claim is paid remains the scheme's decision.
Questions practices ask first.
How far back can old claims be worked?
That depends on the scheme's rules and the age of the claim. Part of the assessment is establishing what is still realistically workable, so time is not spent on claims that cannot move.
How is this charged?
No commission and no percentage of what is recovered. HealthAdmin works on a transparent, scope-based professional fee: ongoing support is quoted as a monthly retainer based on the agreed scope, workload and volume, and once-off backlog or clearance projects are assessed and quoted separately on volume, complexity and the age of the work. Everything is agreed in writing before any work begins.
Do you contact our patients?
No. This work is with medical schemes and administrators, not with your patients.
The rest of what HealthAdmin handles
All servicesPMB Support
PMBs are governed by their own rules and claims are assessed against those rules.
Learn moreAuthorisations & Motivations
HealthAdmin supports the administrative and funding process around clinical motivations.
Learn moreMedical Scheme Liaison
Medical scheme queries, escalations and correspondence take a practice's front desk out of the room.
Learn moreRemote Practice Support
Not every practice needs another full-time administrator.
Learn more
Remote support for practices across all nine provinces. Call 084 301 6520.
Where is your practice losing time or revenue?
Tell us where the administrative pressure sits. PMBs, claims, authorisations, scheme queries, or a backlog nobody has time to work.
Please do not submit patient medical information through this website.