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IconMANAGED HEALTHCARE SERVICE PROVIDERS

Access Health South Africa (Pty) Ltd

Managed Healthcare Organisation.
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Aganang HIV Resource Centre

Aganang has developed a comprehensive and holistic HIV and AIDS management programme. Our programme is based on sound scientific principles that allow measurement of actual outcomes. Aganang continuously updates and enhances its products through its relationship with academic institutions, ...
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Aid for Aids (Pty) Ltd

Since its launch in 1998, Aid for AIDS has provided services to companies and medical aid schemes throughout Africa and more than 30 000 people living with HIV and AIDS are registered on its programme. Aid for AIDS also plays a leading role in collaborating and participating with government-led task ...
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Allcare Administrators (Pty) Ltd

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. This flexibility is evidenced by such widely different schemes as the CAWMED plan which has between 300 and ...
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Aloe Management (Pty) Ltd

Managed Healthcare Organisation.
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Calabash Health Solutions (Pty) Ltd

For the ancient clans of the skilled Kalahari San, the use of the Calabash dates so far back that it is almost lost in the mists of time. This functional instrument was utilised to carry their most valued possession - water. Kept simply in their natural state or intricately decorated, this quintessential ...
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Calibre Clinical Consultants cc

Calibre Clinical Consultants (Calibre) is at the forefront of the provision of integrated employee health and customer workplace wellness programmes in terms of capacity, quality, innovation and value. As part of it’s ongoing mission to improve the quality of life of employees and their family members, ...
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Care Cross Health (Pty) Ltd

CareCross Health is a leader in the primary healthcare market. By developing key partnerships with doctors, dentists and optometrists we provide affordable and quality primary healthcare to people across South Africa. Through our national network of CareCross Health service providers we offer medical ...
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Centre for Diabetes and Endocrinology Pty (Ltd)

The Centre for Diabetes and Endocrinology (Pty) Ltd (CDE) is the first and leading stakeholder in the managed care of diabetes in South Africa. We are a Registered Managed Care Organisation with a well-established nationwide Preferred Provider Network (PPN) of over 200 "Centres for Diabetes" that deliver ...
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Cheiron Health Technologies (Pty) Ltd

Managed Healthcare Organisation.
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Clinical Partners (Pty) Ltd

Managed Healthcare Organisation.
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Dental Information Systems (Pty) Ltd

Denis offers a unique set of insured dental benefits, managed by a powerful rules-based management system, which enables dental costs to be effectively managed to the benefit of patients, the medical schemes and dentists alike. The Denis team of over 100 staff members includes 6 full time dentists, ...
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Discovery Health (Pty) Ltd

People are at the centre of Discovery Health and everything we do. With our members in mind, we pioneered products such as the Medical Savings Account and Vitality. Discovery Health empowers you, more than any other health insurer, to take control of your health and manage your day-to-day spend.
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East Cape Medical Business Systems Limited t/a Ecipa Healthcare

ECIPA Healthcare is a 10-yr young Company Registered in 1996, with its focus on providing Quality Healthcare-delivery Solutions; Its flagship product as A Managed Care Organisation registered with the Council for Medical Schemes, is a Pioneering Dr-driven Medical Care Option offered under the banner ...
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Emerging Market Healthcare Ltd

Principle Product: Managed Healthcare Solutions combined with practice and network administration. Other Products: Systems and Software Support; Sales and Marketing of Medical Aid Products; Procurement of Products within Medical Industry; Education and Training on Healthcare Service Delivery.
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Enablemed (Pty) Ltd

Managed Healthcare Organisation.
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Eternity Healthcare (Pty) Ltd

In keeping with the general trend away from a focus on illness, Eternity’s managed healthcare approach emphasises health and well-being. Through the wellness programmes, quality of life management and modern managed care programmes Eternity addresses the unique needs to its members. Traditional managed ...
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Eyenet (Pty) Ltd

Managed Healthcare Organisation.
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Faranani Healthcare Management (Pty) Ltd

This is a wholly owned subsidiary of Faranani Health Solutions Ltd through which it conducts it’s core business. It was previously a joint venture with Afrox Hospitals (now Life Healthcare) into which FHS had placed it’s whole core business. Withdrawal of Life Healthcare led FHS to assume 100% ownership ...
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HDS Medical t/a Multimed Healthcare Administrators

Managed Healthcare Organisation.
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Health Partners

Managed Healthcare Organisation.
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HIV Managed Care Solutions (Pty) Ltd t/a Careworks

CareWorks is a managed healthcare company specialising in all facets of HIV/AIDS management. CareWorks has been formed out of the collaboration between the Viral Assistance Centre (VAC)and CareCross Health. VAC and CareCross have combined their expertise in Chronic Disease Management and HIV/AIDS as ...
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Huntrex 5 (Pty) Ltd t/a RX Health

The objective of Rx health is to control risk within the scheme, with a dedicated focus on the management of drug utilization and affordable quality health outcomes.
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Ingwe Risk Management (Pty) Ltd

Managed Healthcare Organisation.
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Insight Medicine Management (Pty) Ltd

Insight Medicine Management (Pty) Ltd. is a specialist Pharmaceutical Managed Care Company dealing with, in particular, the issues of pharmaceutical utilisation and expenditure. The Insight team consists of specialist, highly qualified pharmacists with several years’ experience in pharmacology, Drug ...
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Iso Leso Optics Ltd

Iso Leso represents its members in advising medical schemes and funders on optical benefits, administration issues and practice profiling. Whenever necessary, it also assists members with various practice management issues including the recovery of outstanding claims. The organisation also advises schemes ...
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Kwazulu Natal Managed Care Coalition (Pty) Ltd

The KwaZulu-Natal Managed Care Coalition (KZNMCC) was brought into being during 1995, by a group of doctors who shared a common vision. This vision was for KZNMCC to become the reference doctor network in the private health care industry in the KwaZulu-Natal region. This would be accomplished by actively ...
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Lifesense Disease Management (Pty) Ltd

The LifeSense Group originated in 1991 with the establishment of the Health Maintenance Organisation - now known as LifeSense Corporate Health Care. In 1999, the company restructured under the LifeSense Group banner in order to incorporate LifeSense Clinic Solutions, LifeSense Disease Management, LifeSense ...
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Lifeworks (Pty) Ltd

Lifeworks specialises in the provision of HIV/AIDS medical support to corporate employers, aid agencies and public (including government) institutions. Our range of medical services cover all aspects of HIV/AIDS risk assessment, diagnosis and treatment support, including HIV Prevalence Surveys, HIV-Testing ...
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Managed Healthcare Systems

Managed Healthcare Systems (MHS) is a managed health care consultancy that provides a service to a broad spectrum of role players throughout the health care industry of South Africa. MHS's offerings include the design, development, ongoing monitoring and management of managed health care solutions, ...
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Medical Services Organisation South Africa (Pty) Ltd

Pharmaceutical Benefit Management Services. Disease Management Services. HIV/AIDS Disease Management Services. Claims Management Services.
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Medicross Healthcare Group (Pty) Ltd

Medicross is a managed healthcare provider network traditionally servicing the Fee-For-Service medical aid and private primary healthcare market. More recently Medicross has expanded the parameters of its operation, utilising its expertise in the fields of Practice Management and Managed Healthcare. ...
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Mediscor PBM (Pty) Ltd

Mediscor PBM is an independent and specialised managed care organisation (MCO). We offer clients a unique combination of high performance technology, industry know-how and measurable results. Rand Merchant Bank, Kagiso Ventures and management jointly own the company. We view our core competency as the ...
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Medscheme Holdings (Pty) Ltd

Medscheme has been at the forefront of developments within the healthcare industry for over 35 years and is today South Africa's premier medical scheme administrator and health risk manager. The company has diversified and our three core businesses - healthcare administration, health risk solutions ...
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Mossco Shelfco 2005 (Pty) Ltd t/a Clinical Services Consulting

Managed Healthcare Organisation.
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MX Health (Pty) Ltd

Managed Healthcare and Medical Aid Administrators.
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National Healthcare Risk Managers

HIV/AIDS Disease Management Services. Disease Management Services. Pharmaceutical Benefit Management Services. Claims Management Services.
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Old Mutual Healthcare (Pty) Ltd

Old Mutual Healthcare is in the business of providing the full range of administration and risk management services for Medical Schemes in Southern Africa. We believe in building long-term partnerships with our clients and apply the full resources of the Old Mutual Group where required to further these ...
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Onecare Health (Pty) Ltd

ONECARE Health is a Managed Care Company that offers healthcare providers the opportunity to become preferred providers to patients who belong to selected medical schemes. ONECARE is based on the principle that providers adhere to treatment protocols designed to help the medical scheme offer better ...
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Opticlear (Pty) Ltd

OptiClear is the culmination of 20 years of expertise in the optical environment. The expertise gained over years of working in the industry, is being applied to the benefit of medical aid schemes, members and providers. Utilisation of the management processes of OptiClear enables schemes to design, ...
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Performance Health (Pty) Ltd

Managed Healthcare Organisation.
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Preferred Provider Negotiators (Pty) Ltd

Managed Healthcare Organisation.
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Prime Cure Health (Pty) Ltd

Prime Cure has an extensive national network of more than 2 500 of the country's finest general practitioners and 1 200 associated healthcare professionals. The company believes that in order to deliver its highly effective and successful managed care services, a comprehensive doctor network incorporating ...
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Private Health Administrators (a division of Sweidan Trust)

A combination of sound administration, integrated healthcare management using strategic interventions and applying the practice of Demand Management®, ensures Private Health Administrators™ (PHA) is the leading healthcare administrator with an unsurpassed track record of service, cost containment ...
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Prosperity Health Managed Care Organisation (Pty) Ltd

Managed Healthcare Organisation.
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Providence Healthcare Risk Managers (Pty) Ltd

PROVIDENCE was established in 1992 with the vision to manage healthcare risk for employers and their employees. Our vision has evolved into the company's current MISSION to manage healthcare risk optimally for our clients to allow them to focus on their core business. Living our mission has led ...
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Q.A Care Plus (Pty) Ltd

Q. A. Care PLUS (Pty) Ltd is an established Managed Health Care Company that is focused on hospital utilisation management, HIV/AIDS counseling, PMB cost management, disease management and trauma expense recovery. On 1st January 2000 it became an independent company within the Statman group of companies ...
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Qualsa Healthcare (Pty) Ltd

Qualsa Healthcare (Pty) Ltd (Qualsa) is an independent health risk management specialist. As a duly accredited managed care organisation, Qualsa conducts its services in full compliance with the Medical Schemes Act 131 of 1998, the Regulations of the aforementioned Act, in accordance with the registered ...
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Riskaid (Pty) Ltd

Managed Healthcare Organisation.
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Scriptpharm Risk Management (Pty) Ltd

Scriptnet is the first and only National Pharmacy Healthcare Network comprising app. 800 pharmacies operating throughout South Africa. Scriptnet specialises in the supply of Prescribed Minimum Benefit (PMB), chronic and acute medication at Single Exit Prices (SEP).
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Silkstar 114 (Pty) Ltd t/a National Health Network

Managed Healthcare Organisation.
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South African Oncology Consortium (Pty) Ltd

The SAOC is an accredited Managed Care Organisation. The SAOC was established to facilitate cost-effective oncology treatment to the broader South African population. In support of its objective, the SAOC has developed a "tiered" oncology treatment guideline structure in which chemotherapy and radiation ...
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Sovereign Health (Pty) Ltd

Sovereign Health has been administering medical schemes since 1963. Under its first guise as NMP Administrators (Pty) Ltd, it was owned by National Medical Plan (NMP), a medical scheme started by a group of KwaZulu-Natal doctors. In April 1998, the administration company seperated from the scheme and ...
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Supplementary Health Services (Pty) Ltd

Managed Healthcare Organisation.
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Udipa Holdings (Pty) Ltd

Managed Healthcare Organisation.
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Veripath (Pty) Ltd

Managed Healthcare Organisation.
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Webshelf Investments NR 10 (Pty) Ltd t/a Dental Risk Company

Managed Healthcare Organisation.
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From The Glossary »

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Net Level Reserve:

A policy reserve computed by a method that makes no allowance for higher first-year expenses. A uniform portion of each year’s premiums paid by the insured is used for reserve purposes. Comes into play in the calculation of in-force premiums where there are cancellations or endorsements part-way through the policy term.
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