A solution ahead of its time

Universal PBM has been a critical part of the healthcare value chain for decades. We pioneered online real-time claims adjudication in the SA healthcare market and remained a leader in online real-time medicine claims adjudication using US patented technology. As acknowledged pioneers in our field we were first-to-market with the following:

• Generic reference pricing
• Therapeutic reference pricing
• Over-the-counter (OTC) medicine benefit
• Online real-time (OLRT) claims adjudication
• Detailed application of medicine formularies and coding
• Chronic medicine management programme
• Concurrent DUR (patient safety rules)
• Performance-based reimbursement for additional savings on generic medicines
• The South African industry coding standard for medicines and surgical products, termed NAPPI codes