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Meet the team

Medihelp currently has more than 500 employees who are highly skilled and well-equipped with the necessary skills and knowledge to provide a customer experience that exceeds expectations. The following is a summary of how we meet our clients’ needs:

Customer Care consultants
Customer Care consultants

Medihelp’s customer service representatives are the first point of contact for most of our customers and act as the face of our organisation. Every consultant undergoes intensive training on Medihelp’s products and services and act according to our values of integrity, transparency, trust and honesty. With an individualised engagement approach, the consultant assesses your individual healthcare needs in detail in order to provide a seamless customer experience. More than 80% of Medihelp’s calls are answered within 20 seconds, and we regularly evaluate our service delivery in order to stay abreast of changing technology and client needs.

Internal audit
Internal audit

Medihelp is serious about good governance and preventing fraud waste and abuse. Our Internal Audit and Forensic Investigations department investigates any unusual or suspicious transaction that has been reported through Medihelp’s various fraud reporting channels. It also conducts proactive investigations in high-risk areas. The department is guided by the Medihelp Fraud and Corruption Policy, and is tightly regulated to ensure that Medihelp complies with relevant legislation. The internal audit team also makes recommendations on how to improve internal control measures and governance processes, and evaluates how effective current risk management procedures in the organisation are.

Our Sales and Marketing teams
Our Sales and Marketing teams

The members of our Sales team know Medihelp’s benefits by heart and are accredited to provide the best advice. They work in close collaboration with advisers who are well acquainted with Medihelp’s product offering to individuals and corporate groups. The Marketing team ensures that we secure optimal brand exposure from countrywide sponsorships. Online marketing campaigns, a website geared to attract interest from potential members, clear and easily understandable communication on a variety of platforms ensure that your Medihelp experience is positive, consistent and on trend, and that our brand reflects our progressive and transparent nature.

Information technology (IT) team
Information technology (IT) team

Information technology (IT) is the very backbone of the medical schemes industry. Our highly skilled IT specialists enable Medihelp to deliver well-developed systems and infrastructure, to ensure that relevant data is collected, claims are paid on time, and benefits are granted accordingly. Security is paramount and all data is kept in a safe environment to ensure confidentiality. We deliver a variety of platforms and mediums for you to engage with Medihelp. These include the Member Zone, a smartphone app for members and advisers, as well as an online Adviser Toolbox.

Membership
Membership

The Membership team is adept at ensuring that Medihelp has your latest details on record, so that we can contact you and keep you updated. This team will assist you with registering your new baby or deregistering your children who have become independent and enrolling them on a suitable Medihelp plan, and will be there for you when a loved one passes away so that you can enjoy continued and uninterrupted membership.

Clinical Benefit Management
Clinical Benefit Management

The Clinical Benefit Management team employs registered nurses who are responsible to pre-authorise patients’ hospital admission when benefits are requested by doctors, hospitals, members and their family members. The team also uses the services of case managers to ensure that patients are admitted to suitable facilities and receive the correct treatment at the appropriate level of care, and that the Scheme is billed for these services as negotiated.

Healthcare provider networks
Healthcare provider networks

Medihelp has contracts in place with quality private networks of healthcare providers, including hospitals, dentists, optometrists and GP’s, whose fees are aligned with Medihelp’s tariff structures. In this way, we keep healthcare services affordable for our members and help to reduce co-payments. If you belong to one of our network plans, you have the benefit of a lower subscription for obtaining benefits with network specialists, hospitals and other service providers.

Medihelp Preferred Pharmacy Network
Medihelp Preferred Pharmacy Network

Medihelp’s Preferred Pharmacy Network consists of more than 1 900 pharmacies who offer Medihelp members the most cost-effective professional fee structure for prescribed medicine. This means that members who visit network pharmacies will not have to pay any excess amounts for higher professional fees which non-network pharmacies charge to dispense medicine items.

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