ABOUT US
Mediscor is a South African pharmaceutical benefits management (PBM) organisation. We specialise in electronic claims processing and the management of medicine benefits, covering more than 2.8 million lives and processing in excess of 180 000 transactions per day.
Our main offering is the ability to electronically adjudicate a medicine provider’s claim in real time against complex financial, clinical and pharmaceutical utilisation rules. We implement a customised set of rules for each client. Various electronic processing solutions are available, including real-time, electronic batch, web input and paper submissions.
OUR SOLUTIONS
We offer high-performance real-time claims processing solutions,
consisting of the following key components
Real-time Electronic Claims Processing
- Data integrity validation
- Eligibility management
- Utilisation management
- Clinical management
- Formulary compliance management
- Provider management
- Price management
- Reference price management
- Benefit validation
Chronic medicine and condition authorisation management
Mediscor ChroniLine is our comprehensive chronic medicine authorisation and condition registration service. Authorisations are performed by qualified pharmacists and pharmacy assistants.
Data Analysis and Reporting
Standard reports:
- Clinical and operational
- Executive summary
- Expenditure
- Service level agreement
- Ad-hoc and customised
Analytical tools:
- Analyzer medicine claims
- Chronilyzer chronic condition registration and medicine authorisation
- Patient Experience Monitor – provider compliance
Pharmacy Network Management
Mediscor provides a comprehensive Pharmacy Network Management service. The service includes engagements with all levels of pharmacy.
Consulting and Advisory
- Benefit-related clinical advice
- Benefit design
- What if studies and impact analysis
- Formulary selection
- Managing claims expenditure
Client Support Services
- Contact centres
- Dedicated client support teams
- Online search facilities
- Patient communications
MEDISOR BY NUMBERS
YEARS OF EXPERIENCE
CLIENTS
COUNTRIES
MILLION LIVES MANAGED
MILLION MONTHLY CLAIMS PROCESSED
PMR AFRICA AWARDS
KEY BENEFITS OF PARTNERING WITH MEDISCOR
Specialists in managing medicine benefits.
Independent and experienced organisation.
Reputable and clinically intelligent systems.
Customised solutions per client and country.
Guaranteed accurate claims processing.
Guaranteed savings from interventions.
OUR CLIENTS
