CareWorks for Medical Schemes
CareWorks provides proactive disease management and treatment services to medical aid members with ongoing counselling and adherence support; linkages to doctors within selected service provider networks; claims management and reporting.
Our multi-lingual, outbound contact centre provides members with psycho-social and logistical support that ensures follow up appointments are being attended and that treatment is being received.
Care coordination is available for chronic diseases of lifestyle such as HIV, Diabetes, Asthma, COPD, Hypertension, Cardiac Failure, HIV, Depression, Bipolar disorder and Substance Abuse, aimed at reducing “lost to follow up” rates of high-risk individuals as well as absenteeism rates.
Telephonic reminders for appointments (pathology/radiology/GP, etc) ensures compliance and reduces complications that may arise (such as drug resistance)
Retrieval of blood results for disease management monitoring followed by calls to clients providing results and ongoing support/education
Inbound advice and support line for issues such as service provider/doctor enquiries; medicine deliveries; drug side-effects and any other relevant information needed
Service authorisations and claims management for all clients ensuring streamlined service access and provider payments
Task driven data systems create efficient disease management achieving 90%+ adherence rates
Ongoing patient/counsellor interactions creates a confidential and trusting basis for clients to access help and advice with issues that may impact on their ongoing wellbeing
Proactive care and disease management reduces private hospital and specialist claims
Healthy outcomes for clients results in reduced absenteeism and a more functional workforce
CareWorks’ proactive disease management and treatment services equips clients and provides them with the knowledge and support to manage and control their condition.
High adherence rates reduce costs to the medical schemes as well as absenteeism in the workplace whilst increasing healthy outcomes.