We specialise in optimising your practice's financial vitality. Partner with us to experience significant shift in clean claim rates, improved AR turnover, and loss mitigation.
Comprehensive Revenue Cycle Management (RCM)
We provide a closed-loop RCM ecosystem that monitors the financial health of your practice from the moment a patient schedules an appointment to the final reconciliation of the account.
Strategic Oversight: We perform forensic analysis of your current billing workflows to identify "revenue leaks" and systemic inefficiencies.
Fiscal Optimisation: By synchronizing clinical data with financial outcomes, we ensure your practice achieves its maximum reimbursement potential without compromising regulatory standards.
Advanced Claims Submission & Real-Time Processing
The difference between a thriving practice and a struggling one is the "Clean Claim Rate." We utilize cutting-edge, data-driven platforms to scrub and validate claims before they reach the schemes.
Frictionless Processing: Our systems provide end-to-end tracking, giving you a transparent view of every claim’s journey.
Denial Mitigation: We proactively address rejection triggers, significantly reducing the "days in accounts receivable" (AR) and accelerating your cash flow.
Patient-Centric Billing & Professional Collections
Managing the financial relationship with patients requires a balance of firmness and professional empathy. Our collections strategy is designed to protect your reputation while securing your earnings.
Structured Recovery: We manage patient statements, navigate complex payment plan negotiations, and provide diligent follow-ups on outstanding balances.
Conflict Resolution: Our team acts as a professional buffer, resolving billing disputes directly with patients and medical aids so you can maintain a focus on clinical care.
Clinical Workflow & EHR Optimisation
An Electronic Health Record (EHR) should empower a clinician, not hinder them. We specialize in optimising your digital infrastructure to ensure that documentation is both comprehensive for care and precise for billing.
Documentation Integrity: We refine charting and ordering workflows to improve the accuracy of clinical data.
Reporting Excellence: Enhanced reporting capabilities allow for deeper insights into patient demographics, clinical outcomes, and practice performance metrics.
Forensic Coding & Billing Policy Audits
In an environment of shifting medical aid rules and ICD-10 updates, compliance is a moving target. Our audit services provide a shield against both revenue loss and legal risk.
Coding Accuracy: We evaluate your use of procedure and diagnosis codes to ensure they align with the latest industry standards.
Risk Mitigation: Regular audits identify discrepancies before they result in costly clawbacks or scheme investigations.
Transitioning into private practice is a significant career milestone. Coreworks Solutions provides a turnkey incubation service for newly registered specialists and allied professionals:
Credentialing & Registration: Seamless handling of registrations with all major South African medical schemes.
Regulatory Guidance: Expert advice on medical coding (Procedure and ICD-10) to ensure your practice is revenue-ready from day one.
Operational Setup: Strategic consultation on administrative workflows, clinic management, and software implementation
Coreworks Solutions provides bespoke credit control, precision billing, and advanced PMA software integration.
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