This product is designed for groups such as Funders, Medical Schemes, and Medical Scheme Administrators.
Full Risk
It is a full risk-transfer (capitation) agreement. It 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