Medical scheme claims and compliance
Can I submit medical aid claims directly from my practice software?
Yes. In HeroMed Core AI the claim is submitted from the same place the invoice is raised: the practitioner signs the note, diagnosis and procedure codes carry through to the invoice, and the claim goes to the scheme in real time, with scheme responses, remittances and reconciliation handled in the same system. Claim switching is built in, so there is nothing separate to arrange or subscribe to.
Written by the HeroMed team · Last reviewed 21 September 2026
What to check in any South African system:
- Is claiming real time, or a batch at the end of the day? Real-time responses let reception fix a rejection while the patient is still in the room.
- Is switching included, or a separate arrangement? In HeroMed Core AI it is built in.
- Do remittances reconcile automatically? Payment against invoice matters as much as submission.
- Do the codes come from the note? If ICD-10 and procedure codes are retyped into the invoice, that is where rejections come from.
- Who confirms before submission? The practitioner reviews and signs the note; nothing is claimed on an unsigned note.
Related: practice software and medical aid claims.