Mediscor is a South African pharmaceutical benefits management (PBM) organisation. We specialise in electronic claims processing and the management of medicine benefits, covering more than 1.8 million lives and processing in excess of 150 000 transactions per day.
Our main offering is the ability to electronically adjudicate a medicine provider’s claim in real-time against complex financial, clinical and pharmaceutical utilisation rules. We implement a customised set of rules for each client. Various electronic processing solutions are available, including real-time, electronic batch, web input and paper submissions.
Since being founded in 1989, our impressive track record in delivering an efficient and effective service, encompassing all areas of medicine management and control, bears testimony to our system capabilities as well as the expertise of our staff. Successful PBM implementations in South Africa, Namibia, Botswana, Lesotho and Swaziland support this claim, and we have regularly managed to drive down medicine expenditure through the application of various cost-saving mechanisms on behalf of our clients.
Mediscor has consistently been recognised by the PMR® Africa Awards Committee. In 2018, we have received three Diamond Arrow awards for being the highest rated managed care organisation in three specialist service categories; namely Technology Services and Electronic Medicine Management, Chronic Medicine Management, and Pharmacy Network Management.
In addition, Mediscor was the first managed care organisation to be granted unconditional accreditation by the South African Council for Medical Schemes.
The company’s shareholding includes members of the executive management team and Pan-African Capital Holdings.