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Healthcare Revenue Cycle Management

AidMe Medical Solutions

A revenue cycle management platform connecting clinics, medical aid funders and patients around claims, authorisations and payments.

  • Django
  • Django REST Framework
  • React
  • PostgreSQL
  • Tailwind CSS
  • Celery
  • Redis
  • Recharts
  • Vite
Live Demo
Type
Healthcare Revenue Cycle Management
My role
Architecture, development & delivery
Core stack
Django, Django REST Framework, React
AidMe service provider dashboard with quick actions and outstanding debts by currency

Context

The Problem

Clinics in Zimbabwe bill several medical aid societies, each with its own rules, tariffs, payment terms and remittance formats. Claims are often tracked in spreadsheets, so it is hard to know what has been submitted, what was paid short and what is still outstanding.

Shortfalls and co-pays that patients owe get lost, remittances have to be checked line by line by hand, and funders have no simple way to manage members, packages and pre-authorisations with the clinics in their network.

What I built

The Solution

I built a multi-tenant platform with separate portals for clinics, funders and patients. Clinics capture visits and claims, and a payer rules engine applies authorisation automatically. Uploaded remittance advice is matched to claims, and any shortpayment becomes a tracked patient debt.

Funders configure benefit packages, enrol members and review claims and pre-authorisations, while patients see their cover, benefit balances and claim history. Reports such as age analysis, recovery rate and rejection analysis show managers where money is stuck.

Capabilities

Key Features

AidMe gives each party in a medical aid claim its own portal: clinics capture visits and claims, funders adjudicate claims and pre-authorisations, and patients can see their cover and benefit balances. Everything is linked, so a claim submitted by a clinic shows up for the funder and, once paid, is matched against the remittance.

  • Claims management

    Capture visits, prepare claims and submit them to medical aid societies.

  • Rules-based authorisation

    A payer rules engine applies authorisation automatically on new claims.

  • Pre-authorisations

    Request and review authorised services across the provider network.

  • Remittance reconciliation

    Upload remittance advice and match it to claims, with shortpays becoming debts.

  • Debts & receivables

    Track co-pays, shortfalls and cash balances in USD and ZWG, with ageing.

  • Members & benefits

    Patient profiles with annual limits, used and remaining benefits per category.

  • Benefit packages

    Funders configure packages with limits, waiting periods and exclusions.

  • Reports

    Age analysis, top owing funders, rejection analysis and recovery rate, with Excel export.

  • Alerts & SMS

    Notification templates and scheduled alerts by email, SMS and WhatsApp (simulated in the demo).

  • Multi-tenant

    Each clinic and funder works in its own isolated workspace.

Who uses it

User Roles

  • Service Provider

    Clinic manager: claims, patients, debts, remittances, reports and alerts.

  • Billing Clerk

    Front desk: day-to-day claim capture, visits and eligibility checks.

  • Funder

    Medical aid admin: packages, members, claims adjudication and authorisations.

  • Client

    Patient: cover, benefit balances, claim history and pre-authorisations.

User experience

Interface & Screenshots

Select any screen to view it full size.
  • Clinic dashboard
  • Claims management
  • Remittance reconciliation
  • Patient debts & ageing
  • Age analysis report
  • Patients & benefit usage
  • Funder dashboard
  • Pre-authorisations
  • Benefit package builder
  • Members by package
  • Patient portal: cover & benefits
  • Patient portal on mobile

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Clinic dashboard with quick actions, cash and medical aid debts in USD and ZWG

Clinic dashboard

Engineering

System Architecture

  1. 01Clients

    • Clinic portalManagers and billing clerks
    • Funder portalMedical aid administrators
    • Client portalPatients and members

  2. 02Frontend

    • React + Vite SPATailwind CSS, Recharts dashboards

  3. 03Application

    • Django REST APIJWT auth, tenant scoping, role permissions
    • Domain modulesClaims, payers, remittances, debts, pre-auth

  4. 04Data & Jobs

    • PostgreSQLTenants, members, claims, payments
    • Celery + RedisScheduled alerts and background jobs
A React single-page app served by Nginx talks to a Django REST API secured with JWT. Data is tenant-scoped in PostgreSQL, and Celery workers handle scheduled jobs such as alerts.

Tools

Technology Stack

Backend
PythonDjangoDjango REST FrameworkJWT authPostgreSQL
Frontend
ReactViteTailwind CSSRechartsAxios
Background jobs
CeleryRedis
Documents & data
pdfplumberopenpyxlRapidFuzzReportLab
Infrastructure
LinuxNginxSentry

Engineering decisions

Challenges & How I Solved Them

  1. 01Every funder has different rules

    The challenge

    Medical aid societies differ in tariffs, payment terms and what needs authorisation, so one fixed workflow does not fit.

    How I solved it

    Modelled each payer's rules as data in a rules engine, so authorisation and expected payment dates are applied per funder without code changes.

  2. 02Matching remittances to claims

    The challenge

    Remittance advice arrives as PDFs and spreadsheets whose names and references rarely match the clinic's records exactly.

    How I solved it

    Parsed remittance files and used fuzzy matching to pair lines with claims, turning any shortpayment into a tracked debt automatically.

  3. 03Three audiences, one source of truth

    The challenge

    Clinics, funders and patients all need to see the same claims and benefits, but each must only see their own data.

    How I solved it

    Built separate portals on one API, with tenant scoping and role permissions enforced on the server.

  4. 04Multiple currencies

    The challenge

    Clinics bill and collect in both US dollars and Zimbabwe Gold (ZWG).

    How I solved it

    Stored currency on every amount and reported debts and receivables per currency instead of mixing them.

Ownership

My Contribution

Designed and developed the platform end to end: data model, Django REST API, React portals, background jobs and deployment.

  • Mapped the claim lifecycle between clinics, funders and patients
  • Designed the multi-tenant data model and payer rules engine
  • Built the Django REST API with JWT authentication and role permissions
  • Built the clinic, funder and patient portals in React with Tailwind CSS and Recharts
  • Implemented remittance parsing, fuzzy matching and debt tracking
  • Deployed the platform with a public one-click demo

Outcomes

Results

Only verified outcomes are listed here.
  • Deployed to production with a public live demo at aidme-medicalsolutions.co.zw
  • [Add verified project metric here]

Live demo available

Try the Live Demo

Explore the system yourself. Pick a role on the demo page and you are signed in instantly, with no credentials needed, to see how each role experiences the platform.

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One-click demo roles

NO LOGIN NEEDED

  • Service Provider

    Clinic manager: claims, members, debts, remittances, reports and alerts.

  • Billing Clerk

    Front desk: day-to-day claim capture, visits and eligibility checks.

  • Funder

    Medical aid admin: packages, members, claims adjudication and authorisations.

  • Client

    Patient: cover, benefit balances, claim history and pre-auths.

Demo accounts use sample data. Notifications are simulated.