Sovereign Health in Durban has commissioned a custom-built medical aid administration system that uses Internet technology in a move to keep the company at the forefront of the medical aid and managed healthcare business in SA.
A division of Medscheme Holdings, Sovereign Health manages and administers medical schemes for National Medical Plan, Beland, Nampak, Netcare, AACMED Primary Care Plan, Vulamed and PG Glass.
It is responsible for the numerous processes involved in the delivery of healthcare to more than 290 000 members.
Designed to deliver on Sovereign Health`s mandate to ensure cost-effectiveness and quality for its clients, the new system was developed by MGX Software Development, an Oracle South Africa business partner, using an Oracle software platform.
David van der Berg, operations director at Sovereign Health, says the system is a complete, integrated and scalable data warehousing and business intelligence infrastructure, which features interactive Internet capabilities to administer claims and manage membership in a virtually paperless environment.
"It also simplifies implementation, supports better decision-making, and supplies fast response for users throughout the enterprise," says Van der Berg.
He says Sovereign Health has found that two critical factors in its success have been the effective management of information and a flexible administration to cope with the changing needs of both the medical care industry and of its clients.
"For example, our administration services needed to be enhanced beyond the basic functions of claims payments and the collection of premiums. Now we are able to offer services such as credit card type transactions at the point of service and - with access to data collected by the new system - our call centre is better equipped to deal with client queries and offer meaningful advice."
The system
Sovereign Health, which has employed Oracle technology for nine years, recently upgraded to an Oracle platform comprising Oracle Internet Developer Suite, Oracle 8i, and Oracle Express.
Mary Waldek, account manager at Oracle, Durban, says Oracle Internet Developer Suite combines leading Oracle application development tools into a single, integrated product.
"Built on Internet standards such as Java, XML, CORBA, and HTML, the Oracle Internet Developer Suite provides a high-performance development environment with the tools companies need to respond to rapidly changing markets and user demands.
"The Oracle Internet Developer Suite allows Sovereign Health to benefit from the flexibility of a set of development tools without sacrificing the portability of an integrated solution," she says.
MGX Software development
Sovereign Health decided in 1992 to standardise on Oracle technology and selected MGX Software Development (formerly CCH) as its long-term IT technology partner. Today its system is fully integrated and runs on an HP Unix server, NT Clients with Oracle as the database.
Dave Carson, regional manager at MGX Software Development, Durban, says: "With Oracle Internet Developer Suite, Sovereign Health has a development environment for all approaches of application development, such as coding, component, declarative and model-based development.
"The company also has a complete set of Business Intelligence tools, which include ad-hoc query, high-quality Web reporting, and advanced analysis, providing flexible and scalable solutions.
"Oracle business intelligence tools and Express OLAP products provide a single integrated software architecture to support strategic decision-making.
"These products address the full spectrum of enterprise business intelligence needs. Oracle`s solutions are sustainable, scaleable, flexible and reliable," Carson adds.
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