For South African Private Medical Practices

Rejected claims. Short-paid claims.
Money your practice earned but never collected.

GoMedPay helps South African medical practices identify, prioritise and recover unresolved medical-aid claims before they become stale, disputed or written off.

Build a 3-page PDF in your browser. No claim data uploaded to GoMedPay.

CA(SA) — SAICA CIA — IIA Regulation 6-aware deadline controls POPIA Operator

Led by a CA(SA) and CIA. Built to work alongside your existing billing team.

The GoMedPay Revenue-Control Framework
26
Payment states tracked
9
Revenue control checkpoints
120
Day claim deadline
30
Day scheme payment rule
Six Questions. Every Practice. Every Day.

What did we earn? What was billed? What was rejected? What was paid? What is stuck? What must be followed up today?

See the full daily checklist ↓
Not Ready to Book a Review?

Run the free Snapshot first.

Upload a rejection or unpaid-claims register in your browser, generate a 3-page PDF, and see where value may be stuck — without sending claim data to GoMedPay.

  • Runs in your browser
  • Supports CSV/XLSX
  • Generates a 3-page PDF
  • No claim data uploaded to GoMedPay
Two Ways to Start
Free Snapshot — browser only

See which rejection categories are costing your practice — no data leaves your browser.

Run the Rejections Snapshot →
Unpaid Claims Review — CA(SA)-led

We review your billing reports, ageing, rejections and bank receipts. Quantified rand gap — no obligation to proceed.

Book an Unpaid Claims Review →
The Daily Revenue-Control Rhythm

Every Practice Should Answer These Six Questions Daily

A medical practice should not wait until month-end to discover what went wrong. GoMedPay turns these six questions into a structured daily routine.

For Practice Managers

For Practice Managers: stop firefighting, start a daily rhythm.

You're held responsible for cash flow but can't control everything that gets typed at the front desk. GoMedPay gives you a repeatable daily claims-control rhythm, plus practice-branded scripts and SOPs your team can run without us in the room.

Download the Practice Manager Claims Checklist
01

What did we earn?

Services delivered and billable work completed. Has every consultation and procedure entered the billing cycle?

02

What was billed?

Claims and invoices raised by the practice. Is every earned service linked to a submitted claim?

03

What was rejected?

Claims rejected by medical aids, switch systems, or billing errors. Has each rejection been corrected and resubmitted?

04

What was paid?

Cash actually received in the bank. Has every remittance been matched to a real bank receipt?

05

What is stuck?

Claims, patient balances, shortfalls, or receipts that require attention before the 120-day window closes.

06

What must be followed up today?

The action list that protects practice cash flow. Not next week. Today.

GoMedPay turns these six questions into a daily revenue-control rhythm for your practice. You cannot manage what you cannot see.

Our Philosophy

We Are Not Debt Collectors.
We Are Revenue Assurance Partners.

GoMedPay does not approach your patients like a third-party debt collector. We help your practice build a stronger, more disciplined admin process so outstanding claims, rejected claims, short payments, patient portions, and bank receipts are handled earlier, more professionally, and under your practice's own brand.

🤝
Patient relationships stay protected

Healthcare is built on trust. All patient communications carry your practice's name — not GoMedPay's.

🏥
Your practice stays in control

Tone, timing, and escalation remain aligned to your practice's policies and standards.

📋
Your admin team gets stronger

We shift your team from reactive follow-up to a proactive daily revenue-control rhythm.

Firm on cash.
Careful with relationships.

Good cash management should not damage patient trust. It should prevent confusion before it becomes conflict.

Doctors work hard to build trust with patients. Our approach to outstanding balances is professional, sensitive, and practice-aligned — helping patients understand their medical aid shortfalls and co-payments before matters become uncomfortable.

The aim is not aggressive collection. The aim is better communication, earlier follow-up, and fewer surprises for everyone.
Book an Unpaid Claims Review →
The Problem

Clinical Work Is Done.
But Is the Money Fully Controlled?

Revenue commonly gets stuck in six places — silently, without triggering any alert in the billing system.

⏱️
Billing lag

Services are delivered but claims are submitted late — approaching the 120-day Regulation 6 cliff.

Medical aid rejection

Claims are rejected and not corrected within the 60-day dispute window. The trail goes cold.

Short payments

Schemes pay less than expected — R140 less per visit, unnoticed across dozens of accounts.

👤
Patient balances

Co-payments and shortfalls are not followed up early. Collection rate drops sharply after 60 days.

🏦
Unmatched receipts

Cash arrives at the bank but is not clearly linked to invoices, patients, or medical aid batches.

📅
Old debt

Balances age quietly until they approach the 3-year prescription period under the Prescription Act.

GoMedPay helps you find the leak before it becomes a write-off.

The GoMedPay Solution

A Clearer Way to Manage the Journey from Billing to Bank

Three practical services. One daily revenue-control system for your practice.

01

Unpaid Claims Review

We review billing reports, aged balances, rejection patterns, patient balances, remittance information, and bank receipts to identify exactly where earned revenue is getting stuck — with rand values against every issue.

Delivered in 10–15 business days

02

Admin Department Strengthening

We help your practice team implement better daily and weekly routines for billing follow-up, rejection tracking, patient communication, and cash reconciliation — using structured SOPs your staff can repeat without needing GoMedPay in the room.

Loop-back SOP on every recovery

03

Daily Cash Visibility with Ledgr

Ledgr is our cloud-based cash visibility tool that imports bank statements and helps classify receipts so the doctor and practice manager can see what has been received, what remains unclear, and what requires follow-up — every day, not just at month-end.

From R1,950/month per entity

Who We Serve

One System. Four Conversations.

The MD (Owner)
Practice Manager
Referring GP
For the Specialist — The Owner

Clinical excellence deserves financial certainty.

Every procedure you perform is a legitimate commercial transaction. GoMedPay ensures that transaction results in cash in your bank — with full Regulation 6 awareness, a structured follow-up process, and no damage to the patient relationships that sustain your practice.

Book an Unpaid Claims Review →

What keeps the MD awake at night

Revenue disappearing between billing and the bank with no explanation
The 120-day Regulation 6 deadline arriving undetected
Being the person who explains the bill to a defensive patient
A billing company whose letters damage a loyal patient relationship
COID/RAF claims distorting the balance sheet for years

26-State Payment Framework shows exactly where every rand is
Pre-120-day escalation on every active claim, every month
Practice-branded communications — your name, not ours
Relationship Hold Protocol for high-value patients
For the Practice Manager — The Operator

Stop the firefighting.
Start the daily rhythm.

GoMedPay gives your team a simple, repeatable daily routine — backed by structured SOPs — that eliminates manual errors and saves hours on reconciliations every week. When complex rejections arrive, we step in as your extra set of hands.

See the SOP Framework

Practical wins for your team

Complex rejections your team doesn't have time to investigate
Manual spreadsheet reconciliations consuming entire mornings
No clear COID process — staff don't know what document is missing

GoMedPay handles complex appeals — extra hands when needed
Ledgr automates daily bank reconciliation (15 minutes vs 3 hours)
Every recovery includes a Loop-Back SOP for permanent learning
For the Referring GP — The Partner

A referral that reflects well on your recommendation.

Your professional reputation travels with every referral. GoMedPay ensures referred patients experience frictionless billing — clear preparation, upfront co-payment communication, no unexpected surprises at reception.

Partner with GoMedPay

What your patients experience

Digital patient preparation guide before the appointment
Authorisation pre-checked before the patient arrives
Co-payment clearly communicated at booking
Relationship Hold Protocol for patients needing special handling
From the RCM Knowledge Hub
🏥

COIDA Claims for Doctors

WCL forms, CompEasy follow-up, delayed payments, VAT bad debt relief, and income tax treatment — the complete guide.

Read the guide →
⏱️

COID & RAF Long-Cycle Claims

Separated ledger, Document Vault, Prescription Watchdog, and 5-year managed resolution for occupational injury and road accident claims.

See the module →
📚

News & Articles

The 120-day cliff, State 26 technical component billing, PMB coding — verified guides for SA specialist practices.

Browse articles →
Free Template — Pre-Expiry Claims Register

Track every claim approaching the 120-day Regulation 6 deadline. Sent immediately.

By confirming, you consent to receiving GoMedPay updates. Unsubscribe anytime.

RCM Knowledge Centre

Frequently Asked Questions

Verified answers from our CA(SA) team. Full library at RCM Knowledge Centre →

Why was my medical aid claim rejected when the patient was covered?+
Coverage is only the starting point. Claims are rejected for operational reasons: late submission (beyond Regulation 6's 120-day window), missing or invalid ICD-10 codes, no pre-authorisation, benefit exhaustion, or non-DSP provider penalties. The fix starts with knowing your rejection reason code.
Sources: Anglo Medical Scheme · Medical Schemes Act Regulation 6
What is the 120-day medical aid claim deadline?+
Most scheme rules set the submission deadline at the last day of the fourth month after the date of service; after that the claim is stale and the scheme is not obliged to pay. Section 59(2) requires schemes to pay within 30 days of receipt. Under Regulation 6, a scheme must flag an erroneous claim within 30 days, then allow 60 days to correct and resubmit.
Source: Medical Schemes Act 131 of 1998, Regulation 6 + s59(2)
Can a medical scheme claw back money already paid?+
Yes. Section 59(3) of the Medical Schemes Act allows a scheme to recover amounts paid in error. GoMedPay detects clawback transactions on every remittance cycle before they age undetected.
Source: Medical Schemes Act 131 of 1998, s59(3)
What does GoMedPay cost?+
Tier 1 (Recovery Only): Recovery-led pricing from 6% of recovered amounts, subject to a disclosed R3,500 monthly minimum on active recovery engagements. Tier 2 (Recovery + Ledgr): Tier 1 rates plus Ledgr from R1,950/month. All fees exclude VAT.
How does GoMedPay handle POPIA obligations?+
GoMedPay operates as a POPIA Operator under Act 4 of 2013. Every engagement includes a signed Data Processing Agreement. Patient communications are practice-branded at all times. Information Officer: Andile Memela CA(SA) ([email protected]).
Source: POPIA Act 4 of 2013 · Information Regulator (inforegulator.org.za)
Browse all RCM questions →
Transparent Pricing

You only pay when we perform.

Recovery-led pricing. Subject to a disclosed R3,500 monthly minimum on active recovery engagements. The found money covers the platform.

Tier 1 — Claims Recovery

Recovery Only

Recovery of rejected, short-paid, and unpaid claims. Recovery-led pricing from 6% of recovered amounts, subject to a disclosed R3,500 monthly minimum on active recovery engagements.

from
6% of recovered amounts
Medical aid claims — 6% of recovered
Patient shortfall 0–90 days — 8% of recovered
Patient balances 90–120 days — 12% of recovered
Legal handover — R850 / account
Minimum monthly — R3,500
Get Started
Tier 3 — Enterprise & Multi-Site

The Multi-Site CFO Package

Full RCM Assurance, GoMed-LongCycle, and named account management for group practices.

custom
Negotiated
Everything in Tier 2
Multi-entity Ledgr support
GoMed-LongCycle module (COID & RAF)
Monthly strategy call — named account manager
Multi-site group practice support available
Contact Us

Illustrative example: We recover R50,000 in medical aid claims. At Tier 1 you pay R3,000 (6%) and keep R47,000. All fees exclude VAT.

Led by a CA(SA) and CIA

GoMedPay is led by Andile Memela CA(SA), CIA — an audit, risk and revenue-control professional with direct experience in medical practice financial management, POPIA operator obligations, and clinical billing compliance. Every engagement is reviewed at principal level.

CA(SA) — SAICA CIA — IIA
Sample Outputs

See What GoMedPay Produces

We show the machinery, not invented results. Download these sample outputs to understand the format before you share any practice data.

Sample Rejections Snapshot

See the 3-page browser-generated output before you share any practice data.

View sample Snapshot PDF
Specimen Unpaid Claims Review

See the type of review output GoMedPay can produce before a recovery engagement starts.

View specimen Review PDF

Sample outputs. We show the machinery, not invented results.

Process Transparency

What Happens After You Request a Review?

Six structured steps. No surprises. No recovery work starts without your approval.

1
Scope & data
We confirm scope and the data we need.
2
Deidentify
You remove patient identifiers where appropriate.
3
Deep review
We review billing, remittances, ageing and rejection patterns.
4
Quantify
We quantify recoverable value and deadline exposure.
5
Findings report
You receive a short findings report and action plan.
6
Your approval first
Recovery work starts only after you approve.
Book an Unpaid Claims Review →

The methodology behind the review: every unresolved claim needs a status, owner, deadline and next action.

Proprietary Payment Framework

Every Rand Needs a Status.
Every Status Needs an Action.

GoMedPay uses a 26-State Payment Classification Framework to map every rand from consultation to receipt — so nothing hides in a grey zone.

Payment StateWhat It Tells the PracticeAction
Consulted — not billedRevenue earned but not yet in the billing cycleUrgent: raise claim
Billed — submitted to switchClaim in transit to the medical aid schemeMonitor
Rejected — correction neededAdmin error, coding gap, or missing documentCorrect and resubmit within 60 days
Short-paid by schemeMedical aid paid less than the tariff rateDispute or invoice patient
PMB misallocated ★ PearlPMB claim funded from savings instead of risk poolDispute: reclaim from risk pool
Patient liable — shortfall or co-payBalance is the patient's responsibilityInvoice patient promptly
Technical component unmatched ★ PearlRadiology scan + report not billed as paired itemsCorrect billing template
Received — unmatched at bankCash in bank but not allocated to a claimReconcile: find source
Late-payment interest ★ PearlScheme paid beyond 30-day s59(2) windowClaim statutory interest
Fully paid — confirmedClaim matched to bank receiptComplete
+ 16 further states classifiedEvery rand has a status. GoMedPay tracks all 26.

★ Pearl States — high-value revenue invisible to standard billing reports. Surfaced on every GoMedPay Unpaid Claims Review.

Ready to See Where Your
Practice Revenue Is Stuck?

Principle 1
Visibility
·
Principle 2
Control
·
Principle 3
Trust

GoMedPay shows you where your money is, helps your team know what to follow up today, and improves collections without damaging patient trust.

CA(SA) + CIA founded · No long-term contracts · POPIA-aligned operator controls · Response within 24–48 hours