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V-MED IS MAKING ALL THE DIFFERENCE AT SELFMED

"Better communication, substantially improved personalised service, more effective claims payment and a new ABSA/Selfmed credit card are just a few of the benefits that Selfmed members have been able to expect since January," says Marthie Bester, marketing director of the 40-year old medical scheme, Selfmed.

The scheme is now jointly administered by Selfmed and V-med, a newly established administrator. According to Bester the scheme was not prepared to hand over its administration to yet another healthcare administrator. Instead the trustees opted to implement a brand new partnership which has seen Selfmed taking complete control of client services and interaction.

V-med, on the other hand, is using the highly reputable Medware system from Neil Harvey and Associates to ensure that the registration of new members, claims payment and collection of contributions will proceed smoothly. Managed healthcare services are being provided by Solutio, an organisation with an impeccable track record in the field of managed healthcare.

"These changes have enabled Selfmed to remain true to its value statement of providing its members simple, sincere and improved service," says Bester.

Selfmed has established its own Service Excellence Centre where highly trained experts are empowered to receive telephone calls or e-mails and to resolve most queries during the first point of contact.

Bester believes there is a need to get back to the basics of providing sound medical cover. Medical cover should be about providing the best possible value to members.

"Few schemes today are really able to provide this. Indeed, the industry regularly stands accused of giving its members less than adequate service and of offering products that have inferior value.

"One of the major problems in South Africa is that many schemes do not take total ownership of their front office and are therefore providing their members and other stakeholders with unacceptably poor service. Too often schemes fail to pay claims on time, ignore member or intermediary queries and complaints, do not explain benefits properly and employ inadequately trained staff members.

"Taking care of our own client services requirements means that Selfmed is now at the forefront when it comes to new services and enhanced member interaction."

Selfmed was once again able to post a market-related average increase of 8,1% while benefits on a number of options have been enhanced or have remained unchanged.

The scheme has opted to remove the savings account on certain of its options following a ruling by the Registrar for Medical Schemes in which no medical scheme is allowed to have or register an option that affords members a choice of savings levels.

"Consequently, the management of day-to-day claims has become the responsibility of scheme members with the additional sweetener of a brand new Selfmed credit card, for those wishing to avail themselves of such a service," says Bester.

The card is offered by Absa Bank and provides a cash mechanism to enable members to deposit funds on a monthly basis. The card can then be used at any healthcare provider where transactions will be authorised immediately, based on the funds available.

"I have long believed that South African medical schemes need to get back to remembering why they exist: to serve their members and to provide them with the maximum possible access to healthcare and service," she concludes.