This product is designed for groups such as Funders, Medical Schemes, and Medical Scheme Administrators.
It is a full risk-transfer (capitation) agreement and provides, in addition to the services included in the Medic Access and Medic Access Enhanced products, a comprehensive basket of services that are “tailor-made” for each client as required:
· Dispatch of appropriate emergency response
· Medical transportation by ambulance, helicopter, or fixed wing aircraft
· Inter-facility transfers
· Interaction with the funder’s clinical risk management team as required for individual case management
· Compliance with funders’ principles and protocols
· Repatriation of mortal remains (if required)
· Claims management – auditing and payment
· Management and quality control of ER24 resources
· Management and quality control of contracted provider network
· Clinical governance
· Interaction with designated representatives from medical schemes and administrators
· Access to comprehensive, real-time reports
· Provision of IFRS4 reports as per the Council of Medical Schemes’ requirements