MediKredit is proud to say that 94% of pharmacies registered with the BHF and SAPC place their trust in MediKredit.

As an electronic health benefit management (HeBM^®) provider, MediKredit offers flexible, stable information technology solutions with real-time smart switching, guaranteeing 99.9% connectivity uptime. MediKredit’s unique patented rule stacking capabilities offer customisable, complex, innovative benefit design, affording the pharmacy provider seamless claim submissions.

MediKredit’s offering includes:

• Online realtime claiming 24/7 with 99.9% guaranteed up-time
• Statements, including auto-statements, for easy reconciliation
• Healthcare funder option lists
  • Updated listing of healthcare funders and their destination or option codes required for the submission of claims
• A tariff code brochure
• Risk Message Responses (RMR^®s) at point of service
  • A wide range of messages assisting the healthcare provider to manage the patient at point of service
  • Ensuring a positive client experience by alerting the patient to potential co-payments
• Patient SMS functionality at point of service
  • Ensuring healthcare funder costs are well managed through interacting at the point of sale, facilitating proactive interventions
  • Facilitating patient buy-in in discussions around more cost-effective medicine and clinical management
• Call centre services
  • Clinical, operational and provider call centre services
• Circulars
  • Industry regulation changes and updates
  • New RMR^®s, including background to the message and pointers on what the provider can do to resolve issues such as an upfront rejection, for example:
    • Medical scheme rule changes
    • Administrator rule changes
• Pharmacy provider network (PPN) connectivity and assistance with complying to specific healthcare funder rules
  • MediKredit engages and collaborates with pharmacies rather than driving down a “least cost” approach to networks
  • The network runs on a “willing pharmacy” basis, where participating pharmacies can commit to the following:
    • To charge members at the healthcare funder specific dispensing fee
    • To avoid additional administration and non-scheme surcharges
    • To drive generic medicine utilisation for all beneficiaries
    • To ensure that reference price co-payments are dealt with by switching beneficiaries to medication below reference prices
    • To comply with such other lawful and reasonable network rules as may be notified to network pharmacies in writing, from time to time
• Increase income to the pharmacy
  • MediKredit negotiates, on behalf of the pharmacy, an increase in their dispensing fee. This is facilitated by the implementation of the Dispensing for Choice (D4C™) functionality
  • D4C™ is a value-added service initiated by MediKredit
  • The aim is to drive down the cost of medication by paying the pharmacy a higher dispensing fee within the legislated dispensing fee framework
  • In return, the pharmacist engages with the patient and encourages the patient to use a less expensive alternative, where available
  • There is no impact to the member as long as the generic item is priced lower than the MMAP^® price. The patient still has the choice to elect not to take the less expensive generic medicine
• Reporting
  • Monthly compliance reports for dispensing fee surcharges, generic utilisation and substitution
  • D4C™ reports