Portal 08 medical aid admin

Medical Aid Portal

Claims in. Decisions out. Members informed.

The ELMED Medical Aid Portal gives scheme administrators a live claims management platform. Review and adjudicate claims, process pre-authorisations, manage member benefits and track copay requests, all auto-generated from clinical activity on the platform.

Who is this for?

Built for Medical Aid Admin

Medical aid scheme administrators and managed care organisations. ELMED auto-generates claims whenever a doctor or pharmacy completes a clinical event, removing manual submission from providers and members.

What you get

Everything in the Medical Aid Portal

Auto-Generated Claims

Every completed consultation and pharmacy dispense on ELMED auto-creates a claim for the member's scheme. No manual submission required.

Claims Adjudication

Review, approve, partially approve or reject claims with reason codes. Member invoices update automatically when a claim is approved.

Pre-Authorisation

Receive, review and approve pre-authorisation requests from doctors and hospitals before procedures take place.

Member Management

View all members, their plans, dependants and benefit usage. Invite new members and manage dependant codes.

Claims Analytics

Track claims volume, top diagnosis codes, prescriber spend, rejection rates and benefit utilisation with live charts.

Member Messaging

Send bulk email communications to all members or filter by plan, condition or benefit status.

Getting started

How to get on ELMED

Register your scheme

Create an account, select Medical Aid and add your scheme name and administrator details.

Get approved and configure benefits

The ELMED team activates your scheme account. Configure benefit limits, PMB categories and plan types.

Receive claims automatically

Every ELMED consultation and dispense in your member base generates a claim in your portal automatically.

Common questions

Frequently Asked Questions

How are claims created on ELMED?

When a doctor completes a consultation or a pharmacy dispenses a prescription for a member, ELMED automatically creates a claim and routes it to your scheme portal.

Can members see their claims?

Yes. Members see all their claims and their status in the patient portal. Approval updates their invoice patient-liable amount automatically.

Does ELMED support PMBs?

Yes. Each benefit can be flagged as a Prescribed Minimum Benefit. PMB claims are highlighted in the adjudication view.

Can we send notifications to members?

Yes. The messaging module lets you send email communications to all members or a filtered subset by plan or benefit status.

Explore more

Related Portals

Ready to join the ELMED ecosystem?

For medical aid scheme administrators only.

POPIA compliant · South African built · Healthcare professionals verified