Medical billing for specialists · Since 2008
Medical billing for specialists and surgeons. Captured right, followed up, collected.
We run the billing for specialist and surgical practices: ICD-10 and tariff code checks, scheme submissions, rejection follow-up, patient collections, a patient accounts helpdesk and month-end reports. Fees from 5% to 8% of what’s actually collected – no hidden costs, no setup fee, no annual increases.
- Founded 2008
- POPIA privacy policy & Information Officer
- No hidden costs · no setup fee · no annual increases
The claim cycle we run for you
- Capture & checkICD-10, tariff codes, modifiers, pre-auth
- Submit to the schemeElectronic (EDI) submission
- Work the rejectionsCorrect, resubmit, follow up PMBs
- Collect from schemes & patientsRespectful patient follow-up and a patient helpdesk
- ReportBilled, paid and outstanding, every month-end
Sound familiar?
The billing problems that cost specialist practices money
Specialist and surgical accounts are harder than a consulting-room bill. These are the problems we take off your desk.
Rejected claims that sit
Rejections need someone to read the reason, fix the claim or authorisation and resubmit – every time.
Scheme rules that keep moving
Every scheme has its own rules on PMBs, authorisations and rates, and they change.
Theatre billing is detailed
ICD-10, procedure codes, modifiers, assistants and anaesthetists all have to line up on one case.
A debtors book that grows
Shortfalls and patient portions get left when nobody owns the follow-up.
Cash flow you can’t see
Without clear reports you don’t know what was billed, paid or still outstanding.
Switching feels risky
Open claims and old debtors make a bureau change feel like more trouble than it’s worth.
What’s included
The whole claim cycle, handled
One fee covers everything below. Your dedicated account administrator is your day-to-day contact.
Patient and membership verification
Membership and dependant details are checked with the scheme before a claim is captured.
ICD-10, tariff and modifier checks
Procedure codes, ICD-10 codes and modifiers are checked against the work done and the scheme’s rules before submission.
Pre-authorisation linking
Authorisation numbers are recorded and linked to the claim, and mismatches with the procedure performed are followed up.
Electronic claim submission
Claims go to medical schemes electronically (EDI), with an end-of-day report from the switching house.
Rejection and short-payment follow-up
Every rejection is reviewed, corrected and resubmitted where the claim is valid, with a record of each follow-up.
PMBs and gap cover
PMB claims are submitted with the supporting codes and followed up; patients get the documents they need for gap cover.
Patient liability collections
Professional, respectful follow-up of the amounts patients owe: co-payments, gaps, shortfalls and amounts their medical scheme doesn’t pay.
Patient accounts helpdesk
Patients bring their account questions to our helpdesk instead of your rooms, so your staff spend less time on billing calls and admin.
Reconciliation
Scheme remittances and your bank statement are reconciled to your accounts, so balances are right.
Month-end and on-demand reports
See what was billed, what schemes and patients paid, and what is still outstanding.
How it works
From first call to monthly reports, in four steps
Free billing review
We talk through how your practice bills today and look at rejections, debtors and reporting. No obligation.
Your quote
A fee for your practice: a percentage of what is collected, with no hidden costs, no setup fee and no annual increases.
Handover and setup
We set your practice up for billing and plan the handover of open claims and debtors with you.
Day-to-day billing
Claims captured, submitted and followed up; patients’ queries answered; month-end reports so you can see what came in.
Specialist focus
We bill for practices such as…
Our work is specialist and surgical billing: theatre lists, procedure and ICD-10 codes, assistants, pre-authorisations and PMBs. If your discipline isn’t listed, ask us – the billing problems are usually the same.
Also for practice managers who want a billing partner they can phone, and specialists opening or switching practices.
- Orthopaedic and spinal surgeons
- General surgeons
- Cardiologists
- Cardiothoracic surgeons
- Gastroenterologists
- Gynaecologists and obstetricians
- Neurologists and neurosurgeons
- Plastic and reconstructive surgeons
- Other specialist surgeons
Fees
Straight answers on what billing costs
Our fees range from 5% to 8% of what’s actually collected, quoted per practice – not a percentage of what is billed. Where your practice falls in the range depends on its volume and workload, and we confirm your rate after the billing review.
- No hidden costs. What’s in the quote is what you pay.
- No setup fee. You don’t pay to get started.
- Billing software included. You don’t pay for billing software separately.
- No annual fee increases.
- One fee covers the full claim cycle – capture, claim checks, submission, follow-up, debtors and reporting.
How our pricing works, with an illustrative example · See an example billing review report
What the billing review looks at
- How claims are captured and submitted today
- Where rejections come from, and how they are followed up
- Patient portions, shortfalls and the age of your debtors
- What reports you get, and what you can’t see
- A fee quote for your practice
We don’t need patient records for the review. Please don’t send any patient information through this website.
Why practices talk to us
Facts you can check before you call
In business since 2008
Forte Medical Solutions was founded in 2008. Billing for specialist practices is all we do.
Fees you can plan around
Quoted per practice. No hidden costs, no setup fee and no annual fee increases.
POPIA-minded handling
A published privacy policy, an Information Officer you can contact, off-site backups and audit trails of claims processing.
A clear switching plan
A step-by-step handover from your current bureau, planned around your contract and open claims.
Free billing review
A no-obligation look at how your practice bills today, before you decide anything.
Easy to reach
Phone or WhatsApp 081 564 8488 during business hours, and a dedicated account administrator once you’re a client.
Is Forte right for you?
Who we work with
Forte is built for
- Specialists and surgeons billing in hospital and in rooms
- Practice managers who want a billing partner they can phone
- Specialists opening a new practice
- Practices switching from another bureau or from in-house billing
Data handling
How we protect your practice and your patients
Billing means handling health information, which POPIA treats as special personal information. These are the practices we follow. Read the detail in our Privacy Policy.
Confidentiality
Patient and practice information is used only to run your billing. It is not sold or shared beyond what billing requires (for example medical schemes and the claims switching house).
Access on a need-to-know basis
Access to your practice’s billing information is limited to the staff who work on your account.
Audit trails
Claims processing leaves an electronic audit trail, so it’s clear what was done to a claim and when.
Off-site backups
Patient, claim and account data is backed up securely to off-site locations.
An Information Officer
A named role responsible for POPIA compliance, contactable at info@forte-medical.co.za.
No patient data through the website
Our website forms are for enquiries only. Patient information moves through the billing process agreed with your practice.
What happens after you contact us
You get in touch
Phone, WhatsApp, email or the form. Tell us your specialty and how your practice bills today – no patient information.
We reply in business hours
By phone, email or WhatsApp, whichever you prefer, to arrange your billing review.
Free billing review
We look at submissions, rejections, debtors and reports, and you get the findings, like our example report.
Your quote
A fee for your practice: a percentage of what is actually collected. No obligation – the decision is yours.
Questions
Quick answers
How is your fee worked out?
What happens to my open claims if I switch?
Do you handle patient accounts and queries?
Is the billing review really free?
Free · no obligation
Book a billing review
Tell us how your practice bills today. We’ll look at how claims are captured and submitted, where rejections and debtors build up, and what we’d change. Then we quote a fee for your practice. If it’s not a fit, you still keep the findings.
- Fees from 5% to 8% of what’s actually collected, quoted per practice
- No hidden costs, no setup fee, no annual increases
- Reply by phone, email or WhatsApp in business hours
Prefer to talk? Call 081 564 8488 or WhatsApp us.