SA's first AI-powered multi-switch claims platform — EDIFACT MEDCLM v0:912:ZA compliant
AI catches rejections before submission — ICD-10 cross-matching, modifier validation, PMB/CDL detection, and clinical-financial alignment checks.
Automatically selects the correct switch for each medical aid scheme. 30+ schemes mapped to administrators, routed to the optimal clearing house.
Real-time or batch submission. EDIFACT MEDCLM or XML format. Retry logic with exponential backoff ensures every claim reaches its destination.
eRA parsing, 3-tier auto-matching (exact → fuzzy → manual), variance analysis, and automatic dispute generation for underpayments.
Eight interconnected modules forming SA's most complete medical aid switching stack
Parser + Generator
Scheme → Admin → Switch mapping
Healthbridge · MediKredit · SwitchOn
7 rule categories, PMB/CDL detection
5 concurrent, 3 retries, exp. backoff
3-tier matching, variance analysis
15 rejection codes, auto-fix
12 tests, 5 categories
Every major South African medical aid scheme routed to the correct administrator and clearing house
| Medical Aid Scheme | Administrator | Primary Switch |
|---|---|---|
| Discovery Health | Discovery Health (Pty) Ltd | Healthbridge |
| Bonitas | Medscheme | MediKredit |
| Medihelp | Medihelp | Healthbridge |
| Momentum Health | Momentum Health Solutions | MediKredit |
| GEMS | GEMS (Gov) | Healthbridge |
| Bestmed | Bestmed | Healthbridge |
| Fedhealth | Fedhealth (Discovery) | Healthbridge |
| Medshield | Medscheme | MediKredit |
| Sizwe Hosmed | Medscheme | MediKredit |
| CompCare | Universal Healthcare | MediKredit |
| Profmed | PPS Healthcare Admin | Healthbridge |
| KeyHealth | Key Health | Healthbridge |
| LA Health | Discovery Health | Healthbridge |
| Bankmed | Bankmed | Healthbridge |
| Polmed | Medscheme | MediKredit |
| Sasolmed | Medscheme | MediKredit |
| Remedi | Remedi | SwitchOn |
| Hosmed | Medscheme | MediKredit |
| Umvuzo Health | Medscheme | MediKredit |
| Transmed | Discovery Health | Healthbridge |
| Mbmed | Medscheme | MediKredit |
| Samwumed | Medscheme | MediKredit |
| AECI Medical Aid | Medscheme | MediKredit |
| Netcare Medical | Discovery Health | Healthbridge |
| Selfmed | Selfmed | SwitchOn |
| Resolution Health | Resolution Health | SwitchOn |
| Spectramed | Spectramed | SwitchOn |
| Platinum Health | Platinum Health | SwitchOn |
| Tiger Brands | Medscheme | MediKredit |
| Makoti Medical | Universal Healthcare | MediKredit |
| Libcare | Universal Healthcare | MediKredit |
Third-party practice management systems can integrate with our switching engine through a structured accreditation process
No third-party EDIFACT library. We parsed the MEDCLM v0:912:ZA specification and built a full parser/generator that handles every segment, element, and composite. This is the foundation everything else runs on.
Not just format validation — clinical cross-matching. The engine checks ICD-10 codes against procedure modifiers, validates PMB/CDL eligibility, and catches the 15 most common rejection patterns before the claim ever leaves the practice.
Practices choose their clearing house — not locked to a single switch vendor. The router maps every scheme to its administrator and optimal switch route, with automatic failover if a switch is down.
The 2023 Competition Tribunal ruling opened the medical aid switching market to new entrants. VisioCorp is the first to build a complete, independent switching engine that takes advantage of this precedent.
“The technology was always buildable. We just built it.”
Whether you're a practice manager, hospital group, or PMS vendor — we'd love to show you how the switching engine can transform your claims workflow.