Bringing Managed Care In-House

September 19, 2018

Dear Members (Selfsure, MED Elite, Selfmed 80%, MEDXXI)

RE: BRINGING MANAGED CARE IN-HOUSE

For over a decade, Selfmed has utilised the services of a third party service provider, responsible for the authorisation of member hospital admissions and treatment in doctor’s rooms.

At the beginning of every year the Trustees and Management Team critically evaluate the operations of the Scheme to identify and implement changes focused on improving the cost impact and member experience.

During the 2018 review, Managed Care, which includes hospital authorisation and case management, was identified as an area of focus. The strategic decision was made to terminate the third party service provider contract and to provide these services in-house. This will have a positive impact on both the costs and the service delivery of the Scheme.

We are excited to announce that from the 21st of September 2018 all Managed Care functions will be provided by Selfmed.

This step allows, for instance, the Scheme to improve the co-ordination of care by facilitating the hospitalisation and specialist care when receiving treatment. This will positively impact on interaction between the member, the specialist, the hospital and the Scheme, further enhancing a seamless experience for our members.

As a Scheme we realise that hospitalisation and specialist treatment can be daunting at the best of times – through direct contact with our caring staff we can ensure that our members have all the necessary information they require and that any uncertainties can be clarified.

Please note: contact numbers and e-mail addresses will all remain the same.

We have communicated with all service providers in this regard. Should you have any questions, you are welcome to contact us on telephone number: 0860 787372 or email us at:  expert@selfmed.co.za.

This is a new chapter in Selfmed’s history and we look forward to using this opportunity to further improve on our services to our members.

Kind regards
Christo Becker
Principal Officer
Selfmed Medical Scheme