ALLCARE ADMINISTRATORS COMPANY PROFILE
The provision of healthcare is a major concern for the future of the people of South Africa. That is why legislation is in place to ensure that all economically active citizens are members of a medical aid scheme, to guarantee the delivery of care at all levels.
There are close to two hundred medical schemes in South Africa, operating with varying degrees of success. Some have collapsed; leaving their members in very difficult circumstances. Others have broadened their scope to include leisure and incentive schemes.
Allcare sees itself as focused on our core business of assisting medical aid schemes to provide the highest quality of service, best value for money and respecting their members as individuals.
It is our aim to be the best administrator in South Africa, not the biggest. We are a niche funder in the highly complex and competitive healthcare market, where the demands of profitability have often caused costs to rise and standards to decline. Allcare's strategy is to be the most efficient in terms of service and cost, operating within an appropriate and manageable size.
Allcare's philosophy is that we must be responsive to members' needs at all times, with speed and efficiency in handling claims, with clarity in eliminating confusion and with promptness in dealing with frustrations.
Allcare Administrators (Pty) Ltd.was established in 1978. It is a privately owned and managed company without responsibilities or financial commitments to other major corporate interests. As such, it can set values and pursue goals and objectives that serve the real interests of all the stakeholders. An innovative healthcare solution, designed by members, for members.
The current regulatory environment does not allow medical schemes much scope to differentiate themselves through product design. Our success has been due to the quality of service to members, guidance to trustees and the financial acumen to ensure successful schemes that provide outstanding value for money.
Our future growth plan will be strictly controlled and phased according to the entry of new schemes joining Allcare. There will be no strain on systems or people and the company will never be overstretched in its resources of skills and systems.
In this way, Allcare will retain a key aspect of its nature and history - a highly personal level of service that recognizes members as individuals, with healthcare requirements that have to be satisfied promptly, effectively and economically. Members can rest assured that Allcare will be there for them when they need it most. Allcare has the expertise to develop new generation schemes without all the confusion regarding thresholds, suited to members who want to management their out-of-hospital costs and require the security of comprehensive benefits.
The management approach of Allcare is based on the ideals of accessibility, accountability and flexibility.
Members of the management team will always be accessible to scheme members who wish to escalate their contact level. Management will also maintain ease of access for Trustees, corporate clients and employees. Accessibility also includes appropriate ongoing communication with members in easily understandable language.
Responsibility for actions, decisions and service standards rests with the management team. By assuming full accountability for company operations, the management will ensure that service delivery remains at its current unparalleled levels.
Allcare does not believe in imported or "one size fits all" solutions. The administration of each individual scheme is approached as a unique exercise in partnership between all the stakeholders. The optimum result, in terms of benefits and value for money, will be designed around the specifics of our country, the nature of the business and the needs of the members.
Allcare currently employees about 70 staff members with special qualifications, skills and experience to fulfil all the functions required. These are organized under the members of the management team.
The executive leadership of Allcare is focused solely on delivering superior quality service at an optimum benefit-to-contribution ratio. This is achieved through streamlining processes and installing cost-effective administration procedures. The management is enthusiastic, results-orientated and focused on healthcare without incentive schemes or lifestyle enhancements becoming more important that the core business.
Apart from all the administrative and financial skills expected of an administrator, Allcare has specific strengths in medical resources. In-house pre-authorisation for procedures is handled by our own medically qualified staff. The extremely efficient call center provides fast, high quality response to member queries and problems.
The Medstar medical aid administration system software is extremely dynamic at the same time as being very stable and robust. Data structures can be altered at a single point at the data dictionary level, making conversions and upgrades easier. The system is compatible with a wide range of hardware and operating systems and is run on a Sun V880 that has the power, throughput and storage to integrate fortnightly payment cycles as well as full disaster recovery compatibility.
Without stressing the structure as it exists, Allcare is geared to expand its capacity to well in excess of 100 000 principal members. However, there are no plans to implement that kind of expansion in a single step. The growth that is anticipated will be organic and will be accommodated comfortably within the existing framework. Whatever expansion plans are considered, they will have to fall within Allcare's fundamental philosophy of individual attention and personal service.
In the annual survey of Professional Management Review magazine, Allcare won the prestigious Diamond Arrow award. Allcare was also the top rated Medical Aid Administrator as scored by 200 HR Directors and senior managers drawn from the largest 500 companies in South Africa. In the corporate ratings, Allcare was the leader in 10 categories, six more that its nearest rival
Perhaps one of Allcare's strongest recommendations is that the Board of Healthcare Funders of South Africa has placed their staff on the Allcare Chamber Medical Scheme. Just below are some testimonials from our clients.
The Altron Medical Aid Scheme in a most solvent position with almost the highest reserves in the industry. We thank you for having turned around the difficult situation we inherited from those who were formerly in charge of this crucial worker benefit.
Allcare Administrators took over the records that were available from the previous administrators and have effected the changeover with a minimum of disruption. They have cleared the backlog of claims and provided the infrastructure to put the administration on a good footing.
I am very satisfied that the transfer of our membership to the Altron Medical Aid went well and at this stage have nothing but praise for the professional way you and your staff are handling our members.
It is essential to member satisfaction that everybody understands exactly what they can and cannot expect and where their contributions go. Allcare pays particular attention to keeping members informed and to making all documentation as understandable and clear as possible.
Stakeholder's education programmes are undertaken with workshops and training for members and for authority figures such as shop stewards. Regular member communications inform them of changes, additions or adjustments to the benefits and contributions. Our philosophy is to be as user-friendly as possible.
An independent judgment of Allcare's success in these fields can be gathered from the PMR annual survey of Medical Aid Administrators for the Highest Attribute Ratings in:
· Communication of general issues and problems
Allcare Medical Aid Administrators prides itself on creating partnerships with its clients to provide healthcare solutions that fit the needs of the company, the employees and their dependants.
· In-depth knowledge of the South African medical