Traditionally the R28 billion medical industry has shied away from technology, but one of South Africa`s most mature commerce service providers (CSP), QEDI, was launched in 1993 and has introduced the use of technology to streamline processes and electronically link medical practitioners, specialists, pharmacies and medical aids.
QEDI - One of the subsidiaries of PQ Africa`s electronic commerce division, processes over 5 million transactions, representing claims to the value of R300 million, every month. The CSP has approximately 4 900 practices (representing 7000 practitioners) connected to their network. These practices submit millions of electronic claims per month to the 179+ medical aids that are connected to QEDI. The total value of claims received exceeded R3,6 Billion for 1998 and the projected total annual claims value for 1999 is over R4.8 billion.
Hennie du Plessis, managing director of QEDI says, "The number of medical aids, complexities of the different rule bases and the sheer number of claims processed, places an unacceptable burden on the industry`s administrative capabilities. By outsourcing the processing of medical aid claims to specialists like ourselves, the medical fraternity`s management and staff can focus on their core competencies. It is our experience that the increased speed of our claims processing systems assists quicker payment and improves cash flow of the service provider."
Du Plessis says, "During 1998, QEDI also expanded its traditional service to offer online validation, eligibility checking, statistical processing, Internet access, secure e-mail services and online queries into the claims database, which allows the service provider to query the status of submitted claims. An interesting avenue that we are pursuing is to offer practices access to debt management functionality - thus alleviating another administrative burden for our clients."
The linking of all major medical aid companies, pharmacies and practitioners now means a system which is fast, efficient, controllable and far more secure.
QEDI also recently won deals to provide networking services to MediKredit and Interpharm, rival companies which offer managed healthcare services. Together, the two organisations provide electronic payment systems to almost all SA pharmacies.
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QEDI
Established in mid 1993, QEDI (Pty) Ltd is a member of the PQ Holdings group and is one of the four companies within the Electronic Commerce Division. The division incorporates the capabilities of Q Data Internet, QEDI, ECnet and SACA.
QEDI`s primary business focus is to electronically transport medical claim data between Healthcare practitioners and Medical Aids to efficiently expedite the prompt payment of medical claims.
Being part of the PQ Holdings Group affords QEDI the support, backup and resources of an established group, which enables the company to grow business and offer value-added services. QEDI retains its impartial stance with regard to software houses and works in conjunction with all the recognised medical software packages.
QEDI (www.qedi.co.za) holds contracts with the majority of Independent Practitioners Associations and other groups and not only transports their members` claims but provides additional services like secure e-mail and Internet browsing.
The QEDI team is committed to ensuring that their services change with the ever changing Healthcare market.
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