Medscheme offers a comprehensive range of fully outsourced quality solutions, including managed healthcare, medical aid administration and health risk management. Medscheme’s offerings cater to medical aids as well as large corporate clients.
Health risk management
Successful health risk management solutions encompass the following elements:
- Positive relationships with healthcare professionals
- General practictioner, specialist and dental networks
- Negotiations and strategic purchasing for clients
- Evaluation of technologies, pharmaceuticals and clinical practice
- Actuarial and health informatics and analyses
- Hospital authorisation
- Case management
- Disease management programmes
- Drug utilisation review
- Pharmacy benefit management
- Actuarial services (benefit design, pricing and utilisation management)
Health administration
Our health administration solutions are made possible with the following:
- Dedicated business units
- Dedicated client contact centres
- Efficient claims processing and payment
- Claims assessing aligned with scheme rules
- Fund management
- Client-centric servicing and support
- Sales and marketing
- Secretarial services