Medical Aid Administrators, the membership administration company behind Medshield Medical Scheme, has implemented MedStar to streamline its business processes and improve customer service levels for the 90 000 Medshield members in its care. This is in line with the company`s intention to broaden the scheme`s predominantly government-focused membership base.
The Web- and e-commerce-enabled medical aid administration solution from local software developer MIP Holdings incorporates the AstraFin financial system and will be fully implemented by April 2003. The deal includes customisation, support and training.
Medical Aid Administrators jointly administers Medshield Medical Scheme with Medscheme, and is responsible for all membership-related issues. Its main functions include capturing of new members` details, distribution of membership cards, collection of contributions and enforcing suspensions and terminations. Medscheme, meanwhile, is responsible for the assessing and processing of claims, payment to service providers and reimbursement of members.
"The relationship between Medscheme and Medical Aid Administrators allows each organisation to focus on its key areas of expertise and ensures that members of Medshield Medical Scheme receive the ultimate in customer service," says Carol Thomas, operations GM at Medical Aid Administrators. "With MedStar we will have the ability to enhance our service as a result of automation and improved business processes."
Thomas says the need for a new system arose when it became clear that its existing Pick system was no longer able to meet the company`s requirements. "The system had to either be rewritten or replaced. Due to the scarcity of local Pick resources we decided to evaluate products on the market and MedStar best matched our requirements."
MedStar is able to interface with all major service providers in the healthcare sector, speeding up the management of the claims process and simplifying this process considerably. It can also interface with Persal, the government`s payroll system, for the collection of members` monthly contributions. This is a major benefit for Medical Aid Administrators, as the majority of Medscheme members are government employees.
Thomas says MedStar is also the most competitively priced medical aid administration solution on the local market. "The fee to MIP is based on a per-member per-month basis, and will result in long-term savings for our members, in line with our drive to contain administration costs.
"The flexibility of MedStar`s database means we can manage each of our members individually, which will enable us to combat the widespread fraud that is undermining the healthcare industry. It will also enable tighter control of the collection of contributions."
Web-enablement of the system, planned for the second phase of implementation early next year, will provide access to Medical Aid Administrators` brokers, who will be able to log on and capture member details and other information.
"MedStar enables medical aid schemes to optimise the way they operate, cutting unnecessary procedures and costs from their workflow," says Don Elliott, MIP Holdings marketing director. "Web- and e-commerce enablement will enable Medical Aid Administrators to interface with its business partners via the Internet, and provide immediate access to member information.
"With integrated workflow and control systems MedStar funnels processes and procedures to enable effective healthcare management by ensuring each step in the procedure trail can be audited and approved to ensure members get the best treatment at the best price."
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