Sizwe signs transaction deal with USKO`s MediSwitch to cut costs

The MediSwitch division of listed IT group USKO has signed a deal to implement its MediSwitch Virtual Private Healthcare Network (VPHN) at Sizwe Medical Fund, one of South Africa`s largest medical aid schemes. The network will facilitate on-line member eligibility checking and the fast secure electronic transfer of pertinent claims related information and is aimed at cutting the schemes` medical administration costs.

"Sizwe Medical Fund has 63,000 principle members and is the eighth largest medical aid fund in this country," says Andrew Jackson, chief executive officer at Sizwe Medical Services. "We are committed to a working partnership with USKO, as we believe MediSwitch provides a progressive Information Technology (IT) solution for the healthcare industry that will help create a sustainable future for our members."

The MediSwitch Virtual Private Healthcare Network (VPHN) provides a single communication connection for SA healthcare service providers to facilitate the real-time electronic transfer of medical fund membership details and claims related information.

"Among the advantages of implementing MediSwitch is the fact that it facilitates real-time checking of member eligibility, benefit availability and booking, and claims are submitted electronically," he says. "The status of medical aid claims can also be fed back to the practitioner and this cuts down on the duplication of submitting electronic claims as well as paper claims."

Jackson says that MediSwitch allows service providers to confirm a member`s listed benefits on-line from the member`s medical aid. "It is also possible to book a benefit on-line, such as a major operation, with the member`s medical aid to guarantee fund availability. This speeds up the authorisation process," he adds.

"The MediSwitch offer is in line with our company`s vision of providing a carefully managed health care programme for our beneficiaries," he says. Founded in 1978, Sizwe was the first black owned Medical Aid Administration company to provide a black medical aid scheme. Traditionally, Sizwe Medical Aid serviced the black employees of major companies, and then moved to provide for the full spectrum at every level from senior management to the employees, explains Jackson.

He says that Sizwe Medical Fund is expanding its criteria for membership to coincide with the new Medical Schemes Act`s open enrolment policy. "This approach is expected to generate rapid growth, and MediSwitch enables our administrative capabilities to meet the challenge," he says.

MediSwitch prevents administrative bottlenecks, explains MediSwitch MD, Rob Abraham. "The key advantage of the on-line system is that it enables managed health care companies to concentrate their efforts on their core business, namely qualitatively managed healthcare."

He says that the system reduces the possibility of data capture errors, and thus also improves the quality of the data analysis. "Sizwe Medical Fund is one of the market leaders in the managed healthcare arena," he adds. "The partnership with MediSwitch will help the organisation to stay ahead of its competitors in the industry," he says.