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 2 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.
Mediscor Medicines Review 2020
The latest Mediscor Medicine Review is available and can be accessed here
PMR.africa 2021 Awards
We are pleased to receive three Diamond Arrow awards from PMR.africa in the following
specialist service categories:
- Technology Services & Electronic
Medicine Management (8.11 out of 10.00)
- Chronic Medicine Management (8.10 out of 10.00)
- Pharmacy Network Management (8.17 out of 10.00)
During the national lockdown, Mediscor will still be delivering services as normal, but we will not be accepting any walk-in visitors to our building. Please make use of our official telephone numbers or e-mail addresses to make contact with us.
The POPI Act
Mediscor is committed to compliance with privacy laws. We value and respect the right to data privacy and will continue to protect personal information in line with requirements stipulated in The Protection of Personal Information Act, 4 of 2013 (POPIA).
Increased data breaches and incidents have left data subjects, responsible parties and operators vulnerable across the world. As a trusted custodian of personal information, Mediscor fulfils both responsibilities as responsible party and operator; and we have put various policies, processes, and governance structures in place to embed data privacy and security by design into our operations to comply with POPIA.
Below is an update on some key actions we have taken to align our data privacy and security practices to POPIA requirements:
- We reviewed our systems and records where personal information is processed and ensured that security safeguards meet POPIA requirements.
- We have appointed an Information Officer to ensure accountability.
- We updated our privacy notices, and relevant contract clauses, processes, policies, and systems to ensure alignment with data privacy requirements.
- We provided privacy and security awareness and training to our employees to enhance our data privacy culture.
We offer a high-performance real-time claims processing solution, consisting of the following key components
Real-time Electronic Claims Processing
- Data integrity validation
- Eligibility management
- Utilisation management
- Clinical management
Chronic Medicine Registration Services
Mediscor ChroniLine® is our comprehensive chronic medicine authorisation service. Authorisations are performed by qualified pharmacists and pharmacy assistants.
Pharmacy Network Management
Mediscor provides a comprehensive Pharmacy Network Management service. The service includes engagement with all levels of pharmacy.
Consulting and Advisory Services
- Benefit-related clinical advice
- Benefit design
- What-if studies and impact analyses
- Formulary selection
Data Analysis and Reporting Services
- Patient Experience Monitor
- Expenditure Overview Report
Client Support Services
- Contact centres
- Dedicated client support teams
- On-line search facilities
- SMS patient communication