Definiti Medical Fund Managers, a medical scheme administrator running MIP Holdings` medical aid administration solution, MedStar, has received unconditional accreditation by the Council for Medical Schemes in compliance with the Medical Schemes Act, becoming the first of its kind in the country to do so.
The Act requires medical scheme administrators to be accredited by the council, which has developed a comprehensive questionnaire and evaluation programme. It is designed to ensure administrators are compliant and competent to administer medical schemes. The evaluation programme covered:
* System assessment
* Member record management
* Contribution management
* Claims management
* Financial management reporting
* Information management and data control
* Customer services
Definiti administers Genesis Medical Scheme which looks after 27 500 lives, and as Warren Venter, MD of Definiti, says: "The accreditation of Definiti, without conditions, endorses our commitment to the delivery of quality healthcare administration services. Administrators not yet accredited are operating illegally and schemes should question why accreditation has not been granted."
The council has posted the conditions attached to those administrators currently accredited on its Web site. At present, Definiti is the only scheme administrator to be accredited with full marks.
Richard Firth, CEO and chairman of MIP Holdings, a major South African systems house and software developer, says: "MedStar, the platform used by Definiti, stores and manages all member information and records. Definiti`s recent accreditation is testimony to our software`s flexibility, scalability, reliability and security, having met the stringent technology requirements necessary for the accreditation."
Control and operation of schemes with MedStar is data-driven, with parameter information set up via system administration menus. Security access control is active at all times, which allows different levels of access to various programs.
Using MedStar, Definiti can manage the administration of new-generation and traditional medical schemes in real-time, allowing assessed claims and their effects on annual limits to be viewed immediately.
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