Medical Aid Remittance Auditing & PMB Underpayment Recovery

You're Losing

Illustration representing financial leakage and lost revenue in healthcare practices

Money

Medical aids underpay, reject, and slip errors in your remittances. Your team isn’t built for constant auditing and the revenue you’ve earned disappears in the backlog. Now imagine an assistant that catches every error, every short payment, every rejection without adding extra workload to your team.

We've built exactly that: A Medical Auditor purpose-engineered to catch every error and rejection; protecting your income without adding to your workload.

The Process

We Began by Defining
8 Core Principles

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Introducing A1RA™

A1RA™ is an engineered, AI-driven Medical Auditor that works with your own data. It feels natural, guided by independent PMB intelligence and shaped with the real medical insights of a medical doctor. Its purpose is simple: to ease the administrative load that weighs down so many healthcare teams.

🗒 A1RA™ audits remittances. It does not submit claims, replace billing systems, or interact with medical aids unless explicitly mandated.

Hello World. Hello A1RA™

The Silent Leak

A1RA™ was built to solve a single, pervasive problem: Medical-Aid Remittance Errors.

They are small, boring, and easy to miss; but they quietly bleed practice revenue every single month. We stop the bleeding.

The DNA

Engineering Precision.
Clinical Insight.

The Engineer

Developed by an Electrical Engineer with 20+ years in software, telecoms, and financial governance.

The Specialist

Shaped with direct insight from a respected South African ENT specialist to fit real workflows.

Agentic Workflow

Built to Act, Not Just Answer.

Most AI is a chatbot waiting for a question. A1RA™ is an auditor waiting for a file.

Drop a remittance -> It recognises format -> Checks logic -> Flags errors.

"The conversation is just the interface... not the intelligence."

Chat UI

Audit Engine

Frequently Asked Questions

Your Questions, Clearly Answered.

Tell Me More About Yourselves?

I'M RASHAAD, THE FOUNDER

I’ve always been a bit of a rebel ... the type who doesn’t follow rules just for the sake of them. I enjoy cleaning things up, but I also love taking them apart, understanding how they work, and putting them back together properly. These days, that manifests in PC building and design; from constantly rearranging my home interior layouts to designing and building my own bathrooms. I ended up teaching myself SketchUp (a 3D-modeling tool) over a single weekend just so I could map it all out, doing most of the work myself short of the tiling and plumbing. It’s something I’ve been doing in one form or another my whole life: I will iterate until it is perfect.

I studied electrical engineering and was always drawn to practical problem-solving. In my first year of university, one of our projects involved dropping a cup of water from three floors up with the goal of spilling the least amount possible. My design ended up being the most effective in the class; not because it was flashy, but because it was carefully designed, tested, refined, and simple. I dropped no water.

That mindset followed me straight into my career. In my very first job, I automated the entire reporting and management system because doing repetitive tasks manually simply didn’t make sense to me. The upside? The team suddenly had a lot of spare time, which inevitably led to more than a few rounds of Microsoft Age of Empires (let’s hope my first boss doesn’t see this ツ).

Around the same time, long before “AI” and “vibe coding” became buzzwords ... I built a bot to buy limited-release sneakers. It wasn't to resell or game the system; it was just to beat the mass bots that grabbed thousands of pairs so I could get a few for myself and my friends to wear. I am output-driven and detail-oriented. When something is messy, inefficient, or unclear, my instinct is to fix it rather than work around it.

Outside of tech, I love cooking the "old school" way. Burgers, biryanis, Turkish, and Asian food ... no shortcuts, no packet mixes, and no half-measures. For me, cooking is no different from building systems: it requires patience, quality ingredients, attention to detail, and respect for the process.

I also love to travel and love new experiences. My favorite place in the world is Malaysia: a melting pot of cultures, food, and modern life. It’s a place that feels unbound by time, where you can step out at any hour, eat incredible food, and be surrounded by genuinely friendly people. That sense of freedom and openness resonates strongly with me.

This isn’t a hype project. It’s the result of years of building, refining, and choosing to do things the right way. At heart, I enjoy solving problems, making the difficult easy, and creating things that simply work and add value to people's lives.

AND INTRODUCING DR. SHURESH LALLA

Dr Lalla is an experienced Ear, Nose and Throat (ENT) surgeon with over 30 years of clinical practice in South Africa. He runs a respected private practice and is widely regarded as one of the country’s leading ENT specialists.

Over the years, Dr Lalla has treated patients at the highest levels of care, including notable people in South Africa such as Nelson Mandela. Beyond these highlights, his career has been built on consistency, trust, and long-term patient care.

He also serves as Head of the Theatre Department at his hospital, where he is closely involved in the operational side of healthcare … from theatre workflows and staffing to efficiency and governance. This gives him a deep, practical understanding of how healthcare systems work day to day.

Importantly, Dr Lalla has always made time in his practice to care for patients who are less fortunate and cannot afford medical treatment. This commitment to fairness, access, and dignity in healthcare is something he practices quietly and consistently.

Outside of medicine, Dr Lalla enjoys golf (a lot, lol) … a sport that reflects the same qualities he brings to his professional life: patience, discipline, and precision.

What exactly does A1RA™ do?

At its core, A1RA™ audits medical aid remittances to identify underpayments, rejections, and PMB non-compliance by analysing your historical claim data at scale.

I could do this myself? So why do I need A1RA™?

In theory, yes. In practice, it requires far more than reviewing individual claims. Remittance PDFs must first be converted into structured, analysis-ready data. From there, meaningful analysis depends on detailed, up-to-date knowledge of procedure codes, tariffs, and PMB rules ... often across hundreds of line items. Even with this expertise, manual analysis is slow and inconsistent. A1RA™ automates the entire process, applies that knowledge systematically, and delivers results at a level of speed and consistency that is extremely difficult to achieve manually.

How is A1RA™ different to a billing bureau ... seems the same to me?

A1RA™ thinks like an independent medical-aid auditor, not a billing system. It starts by understanding what the doctor is actually asking (underpayment, PMB compliance, trends), then reviews historical remittance outcomes as a dataset to assess whether payments were fair, correct, and compliant ... including on claims that were marked as “paid.” It interprets payment behaviour over time, considers rejection reasons, distinguishes correct adjudications from errors, and recommends proportionate next steps that are defensible to medical aids and regulators.

A billing bureau, by contrast, is an operational system: it submits and resubmits individual claims, tracks rejections and collections, and generally assumes that once a claim is paid, it was paid correctly. Billing systems process transactions; A1RA™ evaluates outcomes and behaviour. They are answering fundamentally different questions.

Is A1RA™ a SaaS platform? Web or Mobile App?

No. A1RA™ is an audit and recovery solution, not a generic SaaS product. Each engagement is bespoke and scoped individually, as recoverable value varies significantly between practices. By design, A1RA™ is not delivered as a traditional web or mobile application, as that would introduce unnecessary privacy risk around sensitive patient data. The approach is driven by the problem we are solving ... not by forcing a SaaS model where it does not fit.

Have to ask again, is my patients data protected?

Yes. By design, no identifiable patient data ever enters the internet. A1RA™ applies a dual-stage pseudonymisation process before any analysis takes place. As a result, even if the data were accessed, it would be stripped of meaningful identifiers and unusable outside the system.

Is the demo and case study using real data? Well ... is it real?

Yes. The analysis presented is real and generated by A1RA™ using its production audit workflow. The pseudonymisation process is genuine. To protect patient privacy, the demo uses a fictitious remittance PDF as the input. However, the case study results; including figures and percentages, are based on real data and real analysis from a real doctor's practice.

Why is the demo output shown in English ONLY?

The analytical output is shown in the model’s original language to preserve authenticity and avoid any interpretation or translation bias.

Do you guarantee recovery?

Outcomes are dependent on medical aid interactions and responses, which are outside our control. As such, no guarantees are made. A1RA™ identifies recoverable opportunities and supports the follow-up process, but final outcomes and timelines are determined by the medical aids themselves.

Do you offer a free demo?

Yes. We can analyse one remittance so you can see the output and understand how A1RA™ highlights missed revenue and recovery opportunities.

What if I want more than just payment analysis; can you do custom requests?

Absolutely. A1RA™ can be thought of as a highly intelligent audit assistant. It can, for example, generate realistic quotes for specific hospital or ICD-10 procedures based on historical data, or produce multi-month reports showing how different medical aids perform in reimbursing your practice. Anything that can be derived from your data, A1RA™ can analyse and surface in a structured, actionable way.

Are there plans for expansion to other countries?

The long-term goal is to expand into other countries. For now, we are taking deliberate first steps and focusing on delivering value to the South African market.

So what can I expect when I sign up?

You’ll receive a welcome pack outlining the engagement scope, data requirements, and next steps. This includes clear instructions on how to submit remittances (Secure Upload options), an overview of the audit process, and what outputs you can expect (for e.g. reports). Once onboarding is complete, A1RA™ begins analysis and shares findings, guidance, and recovery-ready outputs as they become available.

Express Your Interest

Tell us what you'd like to explore and we’ll reach out shortly. Whether you're booking a demo or asking a question, we’ll guide you through the next steps.

Introducing A1RA™

The Audit Process

Market Coverage You Can Trust!

85–90% of All Major Schemes Covered! (More Planned)