Welcome to the SpesNet API Gateway

Here you will find all information regarding the use and instructions of your various services offered through REST Api's.

Services offered

Member Indicative Premium

The member indicative premium service allows the ability to check whether or not a registered South African ID number has any medical scheme commitments. Further more, in cases where possible the members total policy contribution (premium) is calculated and provided as part of the response.

• Scope : mip.api
• NuGet package : SpesNetGroup.IndicativePremiumResources

Designated Service Provider

The Provider Service hosts a means of estabilishing the credibility and viability of a designated service provider enlisted in South Africa. This service is used to validate the correctness and currentness of a given service provider.

• Scope : dsp.api
• NuGet package : SpesNetGroup.ProviderResources

Eligibility

The service objective is to ensure the medical claim is properly validated for the client to be able to pay the correct amount and the medical scheme reimburses the claim correctly in line with their maximum liability and ensuring clinical validity and accuracy of the claim.

• Scope : es.api
• NuGet package : SpesNetGroup.EligibilityResources

Health Code Index

Health Code Index, provides a clinically appropriate cross map between RPL procedure codes (National Health Reference Price List), ICD-10 and CPT4 (CCSA)

• Scope : hci.api
• NuGet package : SpesNetGroup.HealthCodeIndexResources

Funders File

Funders File, provides funder information,containing scheme administrators, schemes and plans

• Scope : ff.api
• NuGet package : SpesNetGroup.FunderFileResources

About Us

SpesNet provides leading-edge healthcare solutions for healthcare providers, medical insurers, administrators and managed care organisations using a combination of technology solutions, healthcare intelligence and artificial intelligence. Our consultative approach ensures the progressive perfection of highly customised, trusted solutions that are tailored to the needs of each individual client.

It is our goal to alleviate the burden of high healthcare costs on communities, while improving the quality of administrative and clinical outcomes, as well as the overall patient experience.

Using intelligent healthcare solutions and highly advanced technologies we innovate, disrupt and transform healthcare administration.