"At the inaugural Fraud, Waste and Abuse Summit held by the Council for Medical Schemes early in 2019, it was revealed that fraudulent and wasteful practices in the medical space cost more than R25 billion a year."
Our team of medical professionals will go through your account and verify each line item and associated code. If there any errors in the account they will let you know. Based on their findings you can go back to your service provider and ask them to correct any mistakes on the account.
Why should you have us verify your medical accounts
Incorrect billing on medical accounts is more common than you think. There are issues with inappropriate coding, excess charging, charging for investigations that were not requested and, charging for inappropriate consumables. All of these can be investigated and corrected when you upload your account in the members area and our professionals can verify your account.
For us to verify your medical account you need to be a member. Select from one of our three Membership plans. From a single person, to a large extended family with up to four grandparents. Join for a year and get two months free. If you do not see a membership plan that is right for you then talk to us, we will accommodate you in any way we can.
Once you are a member you will have instant access to the members area where you can upload your accounts to our medical professionals. The easiest thing to do would be to take a picture with your mobile, but you can also select files on your computer or mobile.
Our team of professionals will go through your account and verify each item. If there are any errors in the account we will let you know. Based on their findings you can go back to your service provider and ask them to correct any mistakes.
If you have any questions then have a look at the About us page where there are some FAQ.
Clarity in our ethos and ethics
Collaboration with resources that represent the best available to detect problems
Communication that is clear, concise, and direct
Value to our clients
A team approach to our individual clients
Systems that represent the new normal – our low-touch approach will still be attentive and professional
Absolute confidentiality in dealing with medical accounts – our systems ensures that !
As a client, we assist you in a step-by-step manner to upload your medical accounts onto our platform along with other documents such as prescriptions, request forms, referral notes and reports. We ask you to fill in some detail about the patient, service provider and expected service. We will then assess all of these in a holistic manner and issue you with a report that you can send to the person who sent you the account in the first place.
All clients will have a unique profile for themselves or each member of their family / group – that helps us control who is using the services and ensures that we have all the information needed to do accurate assessments of the accounts.
If need be, we will assist you with accessing the correct channels to make complaints to the Council for Medical Schemes, the Health Professions Council of South Africa or the Consumer Goods and Services ombudsman.
Medical Schemes have two sources of funds that they pay from – those that are in the scheme risk pool and those that come out of savings accounts or day to day benefits. The in-house scrutiny of those can differ widely depending on who is paying.
All Medical Schemes in South Africa are controlled by a statutory body – the Council for Medical Schemes – they do a good job – but can be difficult to navigate.
The Medical Schemes spend immense amounts of money defining and explaining your benefits. Do you spend the same amount of time understanding them? If not, maybe we can assist.
Also, when detail is examined by actual humans (rather than machines), we find issues with allocations from savings accounts rather than risk pools, issues where a simple registration with your scheme could change where payment is made from. Issues where Hospital Authorisations have not been corrected to reflect correct length of stay.
Firstly, your passwords are unique to you, our IT guys cannot even access them. We have state of the art access control for our uploading system over a secure connection. All your claims are loaded onto a secure server and processed by suitably qualified professional assessors.
We are fully POPI compliant. We understand the intricacies of dealing with confidential medical information.
Our financial transactions are performed through a trusted payment platform which should give piece of mind to any client.
Vavanya (Pty) Ltd is an independent, owner managed South African company that was conceived and born in the Pandemic that is Covid-19. The name originates from the Xhosa word for “test” and that is what we do – we test the veracity and accuracy of the accounts that you get from your medical service providers.
This team of Healthcare, Paramedical and IT professionals have worked together for 20+ years – we are so committed to this service that even our accountant has a medical background.
Obviously – we hope that you or your family do not get ill and incur medical bills. But if you do, we will ensure that those bills correctly reflect the services you received.
An experienced team of Medical and IT professionals who have been in this industry for over 20 years. We actively work in the FWA (Fraud, Waste and Abuse) environment for medical funders in South Africa and have done so for many years.
We provide advice on all medical, paramedical and hospital accounts. From coding to charging and pricing. We assist you by providing you with knowledge and context to have an informed discussion with your medical service provider or hospital or even your medical aid as to why the account has errors or why you have been charged for items not requested or not supplied. If your account is correct, we will tell you. However, if we can advise on altering the scale of future accounts, we will do that as well.
To ensure that errors haven’t crept in, to ensure that you are not being overcharged and to confirm that the account submitted to you reflects the services that you received. It will also allow you to make future informed choices about medical services that you or your family seek out.
It is a fact that, whilst you received world-class professional medical services, the billing often reflects a lessor level of administrative competence. We are there to ascertain if those accounts match up to the same high standard as that of your medical service provider.
Medical Accounts are not an exact science. It must be remembered that medical accounts often do not come from your Doctor but from a billing agency staffed by non-medical personnel.
There are issues with inappropriate coding, excess charging, charging for investigations that were not requested and, charging for inappropriate consumables.
All of these can be corrected with our advice! You may not save on the submitted account but you will save in the future ! Let’s face it – the devil is in the detail ! – And we understand that detail !
Our pricing structure incorporates Individuals, Unitary families (with up to three children under 21), Extended families (with up to four grandparents included) and an offer for Corporates who have a sense of responsibility to their employees and dependants
You may also elect to invest in a yearly membership where you get two months for free.