Medscheme is South Africa's premier medical scheme administrator and health risk manager. MMI (previously known as CareCross) Call Centre –, Your choice of Plan, Membership and Credit Control Queries –, HIV and AIDS Management Programme with Aid for AIDS –, horizon authorisations at medscheme.co.za, Board of Healthcare Funders (Southern Africa), Middestad Centre, Shop C7, 1st Floor, Cnr Charles and West Burger Streets, Bloemfontein, Icon Building, Ground Floor, Cnr Lower Long Street and Hans Strijdom Avenue, Cape Town, 102 Stephen Dlamini Road, Musgrave, Durban, Shop 11, Medicover Building, 22 Knowles Street, Witkoppies, Klerksdorp, Bosveld Boulevard Park, Shop 6, Cnr Chris Hani and Joe Slovo Streets, Onverwacht, Lephalale, Union Square Unit G2, 44 Mostert Street, Nelspruit, Shop 2, Ground Floor, Shoprite Checkers Centre, Cnr Hans van Rensburg & Grobler Streets, Polokwane, Block 6, Greenacres Office Park, 2nd Avenue, Newton Park, Port Elizabeth, Nedbank Plaza, Shop 17, Ground Floor, 361 Steve Biko Street, Pretoria, Flora Centre – Entrance 2, Shop 21 and 22, Cnr Ontdekkers and Conrad Roads, Florida North, Roodepoort, Grand Palace, Unit A2, 2302 Heunis Street, Secunda, 36 Merriman Avenue, Ground Floor, Vereeniging. For More Info contact our Client Service Centre or send us an email. Fax +230 403 5088/89. We also contract and manage a large Pharmacy Network of approximately 1 800 pharmacies that include corporate groups, independent pharmacies and courier pharmacies. 1. We thank our healthcare providers for their continued commitment to participate in our networks and encourage new providers to join us in our mission to provide access to affordable, high quality healthcare through sustainable partnerships. agree to enter a peer management process for ‘poor’ performance. SERVICE PROVIDERS: SUBMISSION OF … Medscheme, in partnership with Quro Medical, has introduced its newly refined Hospital-at-Home offering. Contact Medscheme +27 11 671 2000. Medscheme’s Specialist Network includes over 3 600 contracted Specialists across all disciplines (including Anaesthetists). We can also assist Scheme’s in taking a collaborative approach with Specialists by developing centres of excellence for the treatment of Scheme members. Welcome to your new Provider login portal. Fundamental to strategic purchasing is the ability to accurately profile healthcare provider services from a cost efficiency and quality perspective. This innovation offers patients and their treating doctors the choice to receive active treatment at home instead of a general hospital ward, without any compromise on the quality of the care. The investigation began in 2019, after a number of complaints by black medical practitioners. Provider Zone. Quality standards, access and cost efficiency drivers are contractually enforced, monitored and managed within our networks to ensure that the strategic objectives are met. 0860 POLMEDor 0860 765 633. 2. Strategic purchasing underpins our approach to building and maintaining sustainable healthcare provider networks as well as the implementation of different payment systems and contractual mechanisms. He held various top management positions within Medscheme and was the Managing Director of Aid for Aids for 10 years. Existing funding models and network agreements focus on addressing specific Specialist costs, e.g. Become a Medshield Provider Medshield Medical Scheme serves approximately 160 000 lives. For these members, the contracted Family Practitioner ensures that their member’s health care is optimally co-ordinated. Member Zone. Medshield Contact Center. www.medscheme.com.na; You are here: » Products and Services » Health Administration » Healthcare Provider Relations. 3. These pharmacies are contracted to charge a set dispensing fee in order to eliminate overcharged member dispensing fees. Contact number: 086 000 2120 or (+27) 10 597 4701 for members outside the borders of South Africa. Contact Medscheme +27 11 671 2000 For media queries contact [email protected]; Countries. Medscheme also focuses on managing utilisation risk and quality, rather than on tariffs (fees) alone as we see it as the true instrument to ensure sustainability of private healthcare. For more information on our added services, call us on 403-5073. Mr R Cowlin has over 23 years’ experience in the medical aid industry and is involved in several aspects of the industry, including administration, marketing, product design and managed care. Customer Call Centre: 021 944 3750 Fax Number: 021 949 4121 Physical Address: 14 Mispel Road Bellville 7530 Email Address: [email protected] Web Address: www.cancernet.co.za The system will recognise your medical membership number and offer you the appropriate menus. GEMS Provider Portal. Compare pay for popular roles and read about the team’s work-life balance. Email [email protected] (benefit and general enquiries) or [email protected] (enquiries about membership only) Call 0860 100 080 (or 011 671 6833) Fax 0860 111 784 (or 011 758 7041) A copy of the Scheme Rules is available on the Medscheme website. Login Medscheme focuses on strategic purchasing or activist paying of healthcare services, which aims to maximise the overall health gain from available resources. If this is your first time accessing the new portal, you will be required to register. Send us a message. Phone Number: 0860 002 153 . www.medscheme.com.na; www.medschemeinternational.com; Medscheme is South Africa's premier medical scheme administrator and health risk manager. Uncover why Medscheme is the best company for you. Medscheme also manages a Dental Network via a contracted supplier who contracts dentists according to set Scheme tariffs and Medscheme formulary. Risk transfer for poor quality is addressed as hospitals are required at a minimum to take financial responsibility for ‘never events’ such as wrong side surgery and falls. Although every effort has been made to ensure that this website gives an accurate explanation of the benefits offered by the Horizon Medical Scheme, please note that this website does not replace the Rules of the Scheme, which take precedence over any wording on this website. Medscheme has implemented and manages several different Hospital Networks, customised to suit our Scheme’s needs. You will then be prompted to enter your membership number, followed by the # key. Contact Medscheme +27 11 671 2000. Similarly the quality of service is measured to allow comparison across facilities and to track trends. Search. Our Optometry management programme ensures the delivery of clinically appropriate and cost effective eye-care within the parameters of each of our Scheme’s optometry benefit design. Should you have any difficulty with registration please do not hesitate to contact our client services on 0860 100 078 for assistance. Subject: Products and Services Enquiry Membership Enquiry Claims Enquiry General Enquiry Your Feedback. Full-name. Where the Prescribed Minimum Benefit (PMB)  risk for member Specialist claims is high, Medscheme is able to contract a Specialist Network to mitigate this risk. MEDSCHEME AND NEHAWU REACH AGREEMENT TO END STRIKE OVER BONUSES JOHANNESBURG, June 4, 2019 – Medscheme, South Africa’s largest health risk management services provider, and the National Education, Health and Allied Workers' Union (Nehawu) have reached an agreement to end a strike over performance bonuses. * Please enter your user name and password Username: ... Change Password Our unique, dedicated and well established engagement structures/forums address Family Practitioner and Specialist related issues, as well as assist in creating joint partnering strategies to address fragmentation and wastage in the healthcare system through structured co-ordination of care initiatives. Medscheme has the largest contracted Family Practitioner Network in South Africa with over 5500 participants that: Our Family Practitioner profiling tool (REPI2) measures practice-specific cost and quality metrics, and our Family Practitioner Peer Management infrastructure are both considered to be the industry-leading standard in South Africa. The system will recognise your medical membership number and offer you the appropriate menus. Medscheme is South Africa's premier medical scheme administrator and health risk manager. Republic of Mauritius. Email [email protected]. Because home is where the healing happens. Contact Medscheme +27 11 671 2000 For media queries contact [email protected]; Countries. Please click here for detailed information on … Strategic purchasing underpins our approach to building and maintaining sustainable healthcare provider networks as well as the implementation of different payment systems and contractual mechanisms. This is why our network and contracting model incorporates the management of high risk members – those members who are most vulnerable and account for a disproportionately large proportion of Scheme spend. Private Bag X1, Century City, 7446. Provider Login - 2020. Search For a Provider. Find out what works well at Medscheme from the people who know best. Medscheme International. Medscheme uses risk-adjusted Diagnosis Related Groups (DRGs) to allow comparison between different providers. Contact Us. Forgot Password ? Medscheme Address: Park Rd, Western Cape, 8001, South Africa City of Cape Town,Post Office box: 38632, Pinelands, Cape Town, 7430 Phone number: 021 514 1450 www.medscheme.com.na; SAMWUMED provides high VALUE medical aid benefits forMunicipality Workers at affordable contributions! First choose option 2, then option 1 for benefits, claims and member-related queries. This programme incorporates automated processes and manual intervention for specific cases. Service provider • Name and practice number • Referring doctor’s practice number • In the case of a group practice, group practice number and ... Email: [email protected] Fax: 011 758 7660 Post: POLMED Private Bag X16 Arcadia 0007! Contact Medscheme +27 11 671 2000. Medscheme focuses on strategic purchasing or activist paying of healthcare services, which aims to maximise the overall health gain from available resources. The zone provides useful scheme contact information and will also help you understand and manage your benefits and claims online. OMSMAF is a closed medical scheme, with membership restricted to Old Mutual employees. Block D, The Forum, Northbank Lane, Century City, Cape Town, South Africa, 7441-33.8922689, 18.504155 Contact Us. Please note: Product rules, limits, terms and conditions apply. Contact Medscheme +27 11 671 2000 For media queries contact [email protected]; Countries. Contact Medscheme +27 11 671 2000 For media queries contact [email protected]; Countries. If you prefer face-to-face assistance, why not visit a Medscheme walk-in centre in your area? Medscheme International 1st Floor, Tower A 1 Cybercity, Ebene Republic of Mauritius Tel +230 403 5073 Fax +230 403 5088/89 [email protected] Complete your email address which you have supplied to the Scheme. Tel +230 403 5073. Here’s When We May Have Enough COVID-19 Vaccine for Herd Immunity. In this way co-payments to members are eliminated. Medscheme Mauritius uses an integrated and flexible Oracle based IT system to provide administrative support to healthcare insurers, employee health benefit schemes, third party healthcare administrators and healthcare providers. Welcome to the improved Service Provider online facility. Postal Address: Private Bag X3045, Randburg, 2125 Email Address: [email protected] By registering (if you have not already done so) you can access Medscheme’s administration system which will allow you to: View claims submitted to the scheme as well as track the status and progress of the claim. These pharmacies are also committed to offering generic alternatives to ensure that the member does not incur any out-of-pocket expenses. Facsimile: +27 10 597 4706. Contact details Client service team 0860 104 121 Fax: 0860 104 123 [email protected] www.fishmed.co.za Hospital pre-authorisation (Standard Option only) 0861 888 118 Physical address Parc du Cap 7 Mispel Road Bellville 7530 Postal address PO Box 15747 Vlaeberg 8018 Home. joint replacements. [email protected]. www.medscheme.com.na; “We are happy with the agreements. The participation criteria for hospitals/hospital groups in the Hospital Network include a commitment to quality of care and standards of care. Where there is a discrepancy between the content provided in the brochure, the website and the Scheme Rules, Scheme Rules will prevail. Below is a guide to assist you with your registration: Complete your “Provider Number”. 1st Floor, Tower A 1 Cybercity, Ebene. Dial 0860 101 103. agree to charge the medical scheme tariff and not levy co-payments, are measured against practice specific quality and cost targets, receive an enhanced fee for being a ‘top’ performer (pay-for performance), ensures exceptional access and coverage for all members. Get the inside scoop on jobs, salaries, top office locations, and CEO insights.