Managed Care
Our Managed Care solution enables healthcare businesses to act as administrators of medical schemes’ hospital benefits. Patients in need of compensation are kept in reliable hands, and the provision of care remains paramount.
Managed Care
Our Managed Care solution enables healthcare businesses to act as administrators of medical schemes’ hospital benefits. Patients in need of compensation are kept in reliable hands, and the provision of care remains paramount.
“The technology you use impresses no one. The experience you create with it is everything.”
Managed Care Features
To effectively manage your benefit administration, the UMS Managed Care solution processes requests for authorisation, assessment, and payment of hospital claims without waylaying the provision of care.
Our team applies business rule logic designed to formalise decision-making in line with clinical and contractual policies. Predictability in outcomes aids medical schemes and patient alike.
The key features of our Managed Care solution include:
- Pre-authorisations
- Case Management
- Member Management
- Scheme Rules and Policies
- Provider Management
- Clinical Code Rules
- Hospital Contracting
- Hospital Claims Repricing