Medical aid billing and invoicing
How long does medical aid take to pay? Payment run dates explained
How long does medical aid take to pay? By law, a scheme has 30 days from receiving a valid claim. In practice a clean claim is often paid sooner, in the scheme’s next payment run, and a problem claim can take months.
This guide explains the rule, how payment runs work, and what to do when a claim goes quiet.
3 October 2026 · 5 min read
The 30-day rule
The regulations under the Medical Schemes Act set the outer limit. A scheme must pay a valid claim within 30 days of receiving it. If the scheme thinks the claim is erroneous or unacceptable, it must tell you so, with reasons, within the same 30 days.
So after 30 days you should have one of two things: payment, or a reason. A claim that has produced neither is the scheme’s problem to explain, and you are entitled to ask.
What decides the medical aid claim turnaround time
| Factor | Effect |
|---|---|
| How the claim was sent | Electronic claims are processed faster than emailed or posted ones |
| Whether it was clean | A claim with a code or member error stops until it is corrected |
| When it arrived | A claim that misses the cut-off waits for the next payment run |
| Who is being paid | Some schemes pay the member and not the provider, depending on the rate you charge |
| The member’s benefits | If benefits are exhausted, nothing is paid however long you wait |
Medical aid payment run dates
Schemes don’t pay claims one at a time. They process them in batches called payment runs, and pay everything approved in that batch on one date. Each run has a cut-off: a claim received after it rolls into the next run.
Every scheme sets its own schedule. Some run weekly, some twice a month. Schemes publish their run dates for providers each year, usually on the provider section of their website or in a notice to registered practices.
People search for a single list of medical aid payment run dates for 2026, but no shared calendar exists. Get the schedule from each administrator you deal with, and note two dates from it: the cut-off, and the payment date.
Use the cut-off
If a scheme’s cut-off is a Tuesday and you submit on Wednesday, you have added a full cycle to your wait. Submitting claims on a fixed day each week, ahead of the cut-offs, shortens the average time to payment more than anything else.
The four-month submission deadline
There is a deadline on your side too. A scheme is not obliged to pay a claim submitted after the last day of the fourth month following the month in which the service was provided.
A session on 10 March must be claimed by 31 July. After that the claim is stale, and the scheme can refuse it however valid it was.
A returned claim has its own clock. If the scheme tells you a claim is erroneous, you have 60 days from that notice to correct and resubmit it. Our guide to why claims are rejected covers the fixes.
When the scheme pays the member
A scheme may pay the member and leave the member to pay you. This commonly happens when you charge more than the scheme’s rate, or when you aren’t on the scheme’s network.
It matters for cash flow. The scheme may have paid within days, but the money is sitting in your client’s account. The remittance advice or the member’s statement shows who was paid. If it was the member, the account is now between you and them, and the client needs a statement and a reminder.
When a claim goes quiet
- 1At two weeks: check that the scheme received the claim. Lost claims are more common than rejected ones.
- 2At 30 days: ask for payment or a reason. Quote the date of submission.
- 3After that: follow up on a fixed schedule, and keep a note of each contact and its reference number.
- 4Before four months: make sure the claim is on record as received, so the submission deadline can’t be used against you.
One email per scheme, listing every unanswered claim, works better than a message per claim. The free payment reminder pack below includes a medical aid chase email, and Wholistic sends that chase for you through its automatic reminders.
Know your own numbers
The useful question is how long each scheme takes to pay you. That number differs between schemes, and it tells you which ones to chase earlier and how much working capital the practice needs.
Track the date each claim was submitted and the date it was paid. Practice Insights shows how quickly clients and schemes pay, and which schemes reject most often.
Common questions
How long does a medical aid have to pay a claim?
Thirty days from receiving a valid claim, under the regulations to the Medical Schemes Act. Within the same period it must give reasons if it considers the claim erroneous.
How long do I have to submit a claim?
Until the last day of the fourth month following the month in which the service was provided. After that the scheme isn’t obliged to pay.
Where do I find a scheme’s payment run dates?
From the scheme or its administrator. Run dates are published to providers each year, usually on the provider section of the website. They differ between schemes.
Time limits are summarised from Regulation 6 of the regulations under the Medical Schemes Act 131 of 1998. Payment run schedules are set by each scheme and change every year.
Sources
In Wholistic
See which claims are outstanding at a glance.
Cash and medical aid invoices, claim tracking, remittances and payment reminders.
See medical aid billing