Matic Health / Scheme callsWORKFLOW
We sit on hold. Your team doesn't.
Matic phones medical aid call centres about auths, claims and payments, and brings back the answer.
TIME SAVEDHours on hold every week, gone.
HOW IT WORKS
From first step to follow-through.
Case needs an answer.
An auth is pending, a claim was rejected, a payment hasn't arrived.
Matic calls.
Navigates the menu and waits on hold.
Asks the right questions.
Specific to that case and that scheme.
Logs the answer.
Reference number, who it spoke to, what was agreed, next step.
Hands over if needed.
If the scheme needs a person or a decision, your team gets everything ready to go.
SCHEME CALLS01 / 05
ILLUSTRATIVE WORKFLOW
✓Pending auth
✓Rejected claim
✓Payment outstanding
Next step ready ✓
Case needs an answer.
ILLUSTRATIVE WORKFLOW
✓Pending auth
✓Rejected claim
✓Payment outstanding
Next step ready ✓
ILLUSTRATIVE WORKFLOW
✓Dialling
✓Menu
✓On hold 18:42
Next step ready ✓
ILLUSTRATIVE WORKFLOW
✓Case reference confirmed
✓Outstanding details requested
✓Next step clarified
Next step ready ✓
ILLUSTRATIVE WORKFLOW
✓Approval confirmed
✓Ref MOM-4471
✓Answer and next step logged
Next step ready ✓
ILLUSTRATIVE WORKFLOW
✓Person required
✓Case summary prepared
✓Team notified
Next step ready ✓
BUILT FOR YOUR PRACTICE
Your schemes. Your questions.
Every scheme’s call centre works differently. We build and test your scheme caller around the schemes you deal with most, the questions your team asks every week, and how you want answers recorded.
INSIDE THE WORKFLOWEvery case shows
Every case shows
its working.
01 / SCHEME CALLS
Auths and outstanding details.
Has the auth been approved, and for what exactly? What’s still outstanding on a queried auth?
✓ Your team stays in controlILLUSTRATIVE WORKFLOW
✓Auth status requested
✓Scope of approval checked
✓Outstanding details logged
Answer on the case ✓
02 / SCHEME CALLS
Claims and payments.
Why was this claim rejected or short-paid? Has the payment been released?
✓ Your team stays in controlILLUSTRATIVE WORKFLOW
✓Rejection reason confirmed
✓Short-payment explanation captured
✓Payment release checked
Reference logged ✓
03 / SCHEME CALLS
Admission changes and extensions.
Updating an admission date or requesting an extension.
✓ Your team stays in controlILLUSTRATIVE WORKFLOW
✓Admission date updated
✓Extension requested
✓Scheme response logged
Next step prepared ✓
WHAT MATIC DOESThe repetitive work,
The repetitive work,
handled.
Calls the schemes your practice uses
Waits on hold and asks case-specific questions
Logs references, answers and agreed next steps
Prepares handovers when a person is needed
Makes decisions and takes over when the scheme needs a person.
Your team's time goes to patients, not hold music, and every scheme conversation is on record.
A HEALTH CHECK FOR YOUR ADMIN
Find out where your practice is losing time and money.
We’ll review your last three months of calls, referrals, auths and rejections, and show you exactly where the leaks are. Free, no obligation, and you keep the report.
Set up around how your practice works. Your team approves everything.
Book a free admin health check ↗