• Introducing Mediscor, the undisputed home of the PBM

• Mediscor’s credentials at a glance

After almost 20 years of unparalleled service excellence more than 1.6 million South Africans are currently benefiting from the pioneering PBM services offered by Mediscor. At present the company provides pharmaceutical benefit management services to more than 42 medical scheme clients administered by 17 different healthcare administrators. Since 2001 Mediscor has welcomed 27 new medical schemes to its client base. In the past year alone eight new medical schemes have joined the Mediscor fold. Since 2002 Mediscor has been awarded a number of PMR Diamond awards for service excellence.

• SA’s first fully accredited pharmaceutical benefit management organisation

Mediscor was the very first pharmaceutical benefit management organisation to be accredited by the Council for Medical Schemes as a Managed Care Organisation (MCO) as we are able to offer a comprehensive healthcare management solution to clients. We process more than 300 000 real-time and 30 000 doctor transactions each day and bring, through the course of our daily activities, tremendous savings to medical scheme clients and ultimately to their members.

• Fully integrated, clinically intelligent, real-time pharmaceutical claims processing

Mediscor PBM offers its clients a fully integrated, clinically intelligent, real-time pharmaceutical claims processing system. Our medicine management offering includes a wide array of services aimed at ensuring value for money, quality services and good communication. These include:

• Electronic claims processing services including gate-keeping services, eligibility services, utilisation management services, clinical management services and pricing management
• Client support services
• Fully integrated pre-authorisation service, including exception management
• Management of medicines for the Chronic Disease List (CDL), Prescribed Minimum Benefits (PMBs) and other conditions
• Medicine management in capitation environments
• On-line medicine expenditure reporting
• Supplementary services including network management, development and implementation of reference price lists, formulary management, price and product file management.

Mediscor has evolved from initially processing pharmacy prescription claims retrospectively in batch format, using paper and computer diskettes, to the high performance real-time system in use today. The Mediscor real-time Pharmaceutical Benefit Management (PBM) system offers Mediscor clients a world class product, not only in the management of medicine benefits, but also as the ultimate system to ensure member and provider satisfaction.

Our track record in delivering an efficient and effective service encompassing all areas of medicine management and control is testimony to our systems as well as the expertise of our staff.

• Mediscor – well positioned for South African growth

With pharmaceuticals being the third highest medical scheme expense in the country, the effective management of medicine benefits is more important than ever before. Our achievements and kept impressive track record and economies of scale embedded in our business have positioned us ideally for aggressive expansion within the South African market.