Pharmacy Benefit Management

Revolutionising Healthcare Claims Processing with MediKredit Integrated Healthcare Solutions, a proud subsidiary of Universal Healthcare

Pioneers in Online Real-Time Claims Processing

MediKredit is a pharmaceutical benefit management company that has been at the forefront of healthcare innovation and claims management in South Africa for over 80 years. Their expertise in electronic health benefit management (HeBM®) spans pharmacy benefit management, claims switching and processing for healthcare providers, provider network management, and real-time connectivity to healthcare funders.

A Legacy of Excellence and Innovation

MediKredit’s proud track record includes being the first to introduce and perfect online real-time claims processing in South Africa. They are committed to providing efficient and patient-centric solutions that drive cost savings while ensuring clinical appropriateness, patient safety, and treatment plan adherence. MediKredit also specialises in end-to-end chronic medicine management and holds an unconditional managed care accreditation from the Council for Medical Schemes. Additionally, MediKredit owns, manage, and maintains the NAPPI® product file, a globally unique national coding system that enables seamless information transfer throughout the healthcare delivery chain.

Pharmacy Benefit Management: Advanced Solutions, Unparalleled Technology

MediKredit’s Pharmacy Benefit Management (PBM) is an international claims processing solution that prioritises patient-centric care. Their US-patented rules engine makes them the ideal partner for managing rising prescription drug costs globally. With a real-time switching and claims adjudication service, they serve approximately three million lives across 1691 health plan options, processing over 100 million claim lines annually.

Exceptional Speed & Accuracy: Leading the Industry

MediKredit’s Pharmacy Benefit Management is renowned for its exceptional speed, accuracy, and robustness in online real-time claims adjudication. They have achieved a well-deserved reputation for providing the fastest and most effective claims processing capability in the market. With a commitment to 99.9% uptime and a guaranteed adjudication time of less than a second, their advanced systems and hardware ensure uninterrupted service. Their proprietary claims adjudication software enables rapid response to client needs and the flexibility to innovate diverse benefit designs through rule configurations.

The Benefits of MediKredit’s Pharmacy Benefit Management: Lasting Solutions for Healthcare

MediKredit’s Pharmacy Benefit Management is uniquely positioned to provide lasting solutions for healthcare challenges and guarantees independence, transparency, and full flexibility. Their innovative product solutions drive significant cost savings while improving health outcomes holistically, ensuring clinical appropriateness, patient safety, and treatment plan adherence. With their consolidated Pharmacy Benefit Management offering, they enable health plans to achieve substantial savings through innovative benefit designs, formulary management, treatment protocols, prior authorisations, reference pricing, networks, and effective patient management.

Driving Healthcare Innovation Solutions

MediKredit’s Pharmacy Benefit Management flexible patented rules engine empowers health plans to manage and innovate multiple benefit designs, formularies, pricing structures, reference pricing, and pharmacy networks while ensuring full patient compliance. With extensive experience in benefit and formulary design and management, as well as pharmacy network management, they offer unique solutions tailored to their clients’ needs. Their online real-time capabilities, prior authorisation and over-coding management, formulary management, network management, health plan benefit design, positive patient experience, and multiple payer-per-claim solutions set them apart in the industry.

Achieving Cost Savings

With MediKredit’s Pharmacy Benefit Management solution, significant cost savings are achieved through innovative benefit designs, formulary management, treatment protocols, prior authorisations, reference pricing, networks, and effective patient management. Their solutions drive sustainable savings while maintaining a patient-centric approach.

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Join the Innovation: Partner with MediKredit Pharmacy Benefit Management

Discover the power of MediKredit’s Pharmacy Benefit Management industry-leading technology and expertise. Partner with them to revolutionise your healthcare claims processing, drive cost savings, and improve patient outcomes. Experience the benefits of their innovative solutions, unrivalled speed, and unparalleled accuracy.

For more information on MediKredit, click on the link below.

Contact Number:  +27 (0)11 770 6000
Call Centre:  +27 (0)86 093 2273
Email Address:  [email protected]