We are not a medical aid.
We make sense of them.
Frustrated with your medical aid?
We can help.
About The Company
Spesbona was founded in 1982. We administer and manage healthcare expenses for Employees of various Employer groups. This includes in-and-out-of-Hospital benefits as well as benefits with regards to chronic medication, hospital reassessments and various protocols as developed during our 37 years in the industry.
Part of the solution to the problems in the healthcare industry is to have a committed party that will act on your behalf, who is skilled and trained within the environment, that do not have a vested interest other than the fee they receive for service rendered to the satisfaction of the consumer, who realizes that the customer is responsible for their remuneration and who will act in good faith and provide fact based answers and solutions. A third party that has established relations within the industry to serve their clients and provide factual answers and solutions through various processes.
Our Service
Currently administering in excess of R40 Million worth of medical accounts per annum.
Spesbona is not a Medical Scheme, as defined in the Medical Schemes Act of 2000.
NHI
(Objectives, Summary and the Bill)
PMB’S
(Prescribed Minimum Benefits)
ICD 10 Codes, Tariff Codes & Nappi Codes
Hospital Authorizations
NHI
(Comments & Concerns)
DSP
(Designated Service Providers)
Medical Scheme Terminology
Individual Products
NHI
(The View Of Spesbona)
CDL
(Chronic Disease List)
Medical Scheme Underwriting
Corporate Solutions
Why Choose Us
37 Year Experience In The Industry
Quick Response - Response Within 24 Hours Or Less
Clinical Staff Available On Call To Advice On Treatment Protocol
Access To Staff - Instant Access Via Your Smartphone
We Act On Your Behalf - With Your Medical Scheme, Service Provider & Will Go All The Way To Assist With The Correct Protocols.
Unique Membership Card With Medical Aid Number & SB Member Number For Easy Access
your professional healthcare manager
Highly motivated staff offers friendly personal and efficient service.
SpesBona Benefits
Apart from intervention by someone else than yourself, with the necessary skills and know-how, to micromanage your healthcare expenses; SpesBona will negotiate with service providers to obtain the most cost-effective clinical treatment and we have developed special skills in assessing claims. A few of our skills include items such as:
Micromanagement Process
This is really the crux of what we do. We don’t just pay accounts on your behalf, we look intelligently at all claims and assess it, whilst taking into account what might develop in the near future.
Dental Benefit
Over a number of years we have been managing and developing software that assists us in assessing dental claims and pre-authorizations on specialized dentistry. This is so successful that it is used by large schemes to manage and control their cost.
Consultations
On your request, we can negotiate favourable rates with your medical practitioner. This is not compulsory, but rather a method to stretch your healthcare rand.
Unnecessary Treatments
Medical accounts aren’t always what you expected. Our team has the skills to interpret all the detail and will liase with you to make sure that you have in fact received the specific service at an appropriate rate.
Obtaining Pre-authorisation On Your Behalf
Obtaining a pre-authorisation is not a guarantee of payment by your Medical Scheme. We ensure that the pre-authorisation obtained correspond to the treatment given and liaise with all the parties to adhere to your Medical Schemes protocols.
Durable Medical Equipment (DME’s)
Ever had to buy expensive prosthesis that has a sublimit in your Scheme? Through our own procurement process, we can save money on expensive and sophisticated products both for internal as well as external usage. A saving of at least 10% is guaranteed!
Emergency Expenses
There are a lot of misconceptions around emergency procedures performed after hours at hospitals. The very first thing to remember is that if you are not admitted to the hospital, in other words you have not received an identification tag around your wrist, you are most probably treated by a private practice next to the hospital.
We Read the Fineprint
It is not our job to question the actions and treatment plans of your service provider. However, when you are engaging in a complex procedure or need a lengthy treatment plan, it is always nice to know that someone can assist you in interpreting the finer detail thereof.
Confusing Medical Bills
When you are sick you probably do not want to argue, especially when it comes to finances. It is comforting to know that there is a third party willing and able to negotiate on your behalf.
Whom do We Assist?
Medical Scheme Members
Non-Medical Scheme Members
Consultations
Testimonials
Contact us
Call Us
medical emergencies
24/7/365
082 875 7615
Email Us
Hours
Mon – Thurs: 07:30 – 16:00
Fri: 07:30 – 15:00
Contact us
