Spesbona Benefits

It's not simply adding value, but ensuring you get value from all the parties involved in your well-being.

What are the unique Spesbona benefits?

Apart from intervention by someone else than yourself, with the necessary skills and know-how, to micromanage your healthcare expenses; Spesbona has successfully negotiated with preferred providers on behalf of their clients, as well as 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. We liaise with you, the service providers and your scheme to ensure that you don't waste your money, while at the same time helping you receive the best possible clinical outcome!

  • Pay Less for Medicine

    The cost of medication can be crippling especially for those who that have to use it on a regular basis. Sometimes one has to choose between medicine and other necessities, and therefore we are proud to announce that we have secured an unsurpassed medicine deal that will fit everyone's pocket. This also includes a formulary that can really help you stretch your healthcare spend!

    Read More

  • 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 has been so successful that it is used by large schemes to manage and control their cost. We apply this tool directly to your MPA, saving you thousands of rands on expensive dentistry! Comparing our average payout against the initial quotes makes for interesting reading for example 2012 actual averages:

      Quoted Accepted & Paid Saving
    Dentures 3082 2628 454
    Crowns 5383 3654 1729
    Implants 11018 6397 4621

  • 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!

  • GP Consultations

    A very favorable rate has been negotiated for General Practitioner visits for SB4I members. Availability of the network in your area will be communicated to you. This is not compulsory, but rather a method to stretch your healthcare rand.

  • Emergency Expenses

    There is a lot of misconceptions around emergency procedures performed afterhours 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. The second thing to remember is that during such an emergency, emotion plays a very big part in making funding decisions. We will take the duress out of the situation and negotiate with all the relevant parties to ensure that you are treated properly and charged accordingly.

  • 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. We will provide clarity as to why these services were needed in the first instance to assure you that your money was well spent!

  • 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. This is especially true when these services might run over different financial years at your scheme for instance, and to plan in advance for the funding should it not all come from the scheme. Planning makes all the difference!

  • Negotiating Skills

    When you are sick you probably do not want to argue, especially when it comes to finances. It is nice to know that there is a third party willing and able to negotiate on your behalf. Whether it is the actual cost of the consultation or apparatus, or even the terms on which it will be settled we are there for you!

  • Confusing Medical Bills

    The healthcare industry is known for complex bills containing various codes and numbers that is very hard to decipher. In the event where there are multiple practices and hospitalisations involved, you need to be an expert to decipher all of it! We will track and trace all the various accounts and make sure that the relevant 3rd parties honor their obligations.

  • Medical Club Benefits

    Apart from the discount we have also compiled our own generic formulary that are based on molecular substitution which means the active ingredient in the product is the same than in the patented product, but at a fraction of the cost. If clients choose to utilize this formulary, further considerable savings will be realized.