This data package populates your software with a complete database of valid medical aids, options, plans and administrators, as well as the associated medical aid codes required for switching to the correct destination. It keeps you up to date with the latest changes due to medical aids being discontinued, amalgamating with others or changing administrators.

The medical aid data also supplies up to date contact details for all medical aids, administrators and managed care companies, making it easy to find a number when you need to phone for authorisation.

This data includes rules and remarks to inform you when, for instance, a certain medical aid will only cover 80% of a consultation fee and a 20% co-payment is mandatory.

Your practice management system requires the correct scheme name and scheme codes at all times to ensure data integrity when electronic invoices are sent via the switch to the medical aid. Medprax will not just keep your medical aid codes up to date, but also your EDI or switching codes. You will no longer have to do laborious manual updates.

The essential medical aid codes are kept up to date at all times to ensure that your claims reach the correct destination the first time.

  • Administrators
  • Scheme Names
  • Plan
  • Option
  • Sub Option (Acute, Chronic, etc.)
  • Managed Care Company
  • Addresses
  • Tel and Fax Numbers, e-mail addresses
  • ICD10 link to Nappi codes
  • CDL Formularies
  • Medikredit codes
  • Mediscor Codes
  • Healthbridge Codes
  • Mediswitch Codes
  • QEDI Codes
  • Exclusion Criteria
  • Service Levies
  • Dispensing Levies
  • Services and Dispensing Rules
  • Calculation table

Terms of Use

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Privacy Policy

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Medprax terms and conditions

Both the software development company and owner of the software must sign a Non-Disclosure Agreement (NDA) with Medprax that will allow them to use the file layouts and demo data for the purpose of development and testing only. No licence will be granted to supply data to any third parties unless agreed upon by Medprax. Medprax will not supply a full data file for software development and testing purposes. Once the NDA has been signed you will receive demo data and file layouts and will then be able to develop the interface. Please note that you will be required to incorporate a Medprax security feature into your software. This will be supplied by Medprax for all desktop software.

File Layouts

File layouts will be supplied in Excel spreadsheets which indicate the different tables and how they link up. The data you use will be supplied in a text delimited format.

Contact us if you have any queries regarding the file layout.

An Interface can be written for the following core products

Active X security feature

We require this feature to keep track of all users of our data files. This is a security feature that looks for an unlock key to activate the Medprax interface. Ideally it will be coupled to the Medprax update menu option. The component supplies a lock key that has to be mailed to Medprax or phoned through for Medprax to respond with an unlock key. If this application cannot be utilised, please contact Medprax and we will discuss alternatives.

Our Business model

Once the software is complete, the end user, doctor or pharmacist using the software will have to register with Medprax individually to receive their weekly updates. Medprax does not allow for the Software developer/owner to distribute the Medprax data on our behalf. All clients/end users using Medprax data will require registration with Medprax.

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Privacy Policy

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Ethical medicine

The list of ethical medicine, which also includes reference pricing that is allocated to each product by the different medical schemes, is essential for all dispensing practices. It will also indicate whether a co-payment is applicable before the patient leaves your rooms. The correct SEP will be listed ensuring rejection free claims.

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Material and injections

The consumable and injection price file is very useful to both dispensing and non-dispensing practices. This file includes all the consumable materials used in your practice, from sutures to gauze to catheters and oxygen masks. These are supplied with current price lists and works with the calculation table within our Medical Aid File to ensure that the correct re-imbursement rates are billed.

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Medical aid schemes

The medical aid file is a necessity in any practice as it contains all the current contact information for each medical scheme, as well as destination codes, switching codes, plans, options and administrators. The file also contains a calculation table that will automatically adjust the billing amount according to the re-imbursement rate of the medical aid you have selected.

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