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Medscheme International Presentation

Mauritius

Our vision

“Creating a world of sustainable

healthcare”

Medscheme

www.medscheme.co.za www.medschemeinternational.com

Our values

“Integrity”

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Proven 40-year track record of leadership in Southern Africa.

Largest managed care provider and third largest healthcare administrator in Southern Africa.

€140 million annual turnover.

40% South Africa market share.

More than 3,000,000 lives under management.

Client base includes 32 leading medical schemes in public and private sectors.

22 offices across Africa and Mauritius.

Highly capable and experienced management team.

2 800 employees.

International BPO operation in Mauritius

Our values

“Integrity”

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Established in Mauritius in 1982

Medscheme acquired 30% stake in 2001; 100% stake in Oct 2010

Only health insurance TPA in local market:

•32% market share (63,000 members)

International BPO facility established in 2007 (VHI):

•Medical coding (ICD9 and ICD10)•Data capture & claims processing•Health care Administration (Mauritius since 1982)

146 employees, 2 shifts

Current capacity for 450 seats over 3 shifts (but scalable)

Proprietary health insurance system (Schema 6) – “system in a box”

Work on client systems via Citrix

Medscheme Holdings

Medscheme Mauritius

Mauritian domestic market

Medscheme International

International BPO contracts

Our vision

“Creating a world of sustainable

healthcare”

Medscheme Mauritius and Medscheme International is a 100% subsidiary of Medscheme holdings (south Africa)

A member of JSE listed Afro centric group.

Our Values“Empowerment”

Our vision

“Creating a world of sustainable

healthcare”

Medscheme operational Divisions

Our Values

“Accountability”

LeadershipMISSION

STATEMENT

We create access to sustainable,

affordable, quality healthcare through the application of

innovation and expertise, delivered

as an efficient, seamless experience

André Meyer - Chief Executive Officer

André joined Alexander Forbes Financial Services in 1987 as a Retirement Fund Consultant and subsequently transferred to Durban, where he headed the local Negotiated Benefits Unit for the company.

He was appointed Divisional Director in 1991 and in 1997 was transferred to the Health Care Consultants Division as Deputy Managing Director later becoming joint Managing Director responsible for the Health Management Solutions and the Communications Division of Alexander Forbes. He also represented Alexander Forbes on the Board of FIHRST Management Services.

In April 2003, André was appointed as Medscheme’s CEO and, supported by the Executive and management teams steered the Group through the successful turnaround strategy and acquisition process.

Lee Callakoppen - Executive Director: Human Capital

Lee obtained a degree in Information Science from the Rand Afrikaans University in 1997 and qualified as an Industrial Sociologist in 1999 after completing his honours. He then furthered his education in Business Management and is currently pursuing an LLB degree.

He began his career in operational management in the retail sector and later moved into Human Capital, holding positions in various industries ranging from retail to telecoms to media. Lee held the position of HR Executive for the Primedia Content Division before joining Medscheme in 2007.

As Executive Director, Human Capital, he is responsible for the continued implementation of Lethimvula Healthcare’s strategy to become an employer of choice.

Our Values

“Accountability”

LeadershipMISSION

STATEMENT

We create access to sustainable,

affordable, quality healthcare through the application of

innovation and expertise, delivered

as an efficient, seamless experience

Anthony Pedersen – Managing Director: Medscheme International Anthony is a qualified Chartered Accountant having completed a Bachelor of

Commerce and an Honours Bachelor of Accounting Science. He completed his training at Arthur Andersen and is a member of both the South African Institute of Chartered Accountants and the New Zealand Institute of Chartered Accountants.

After a short time as Head of Internal Audit in the retail sector, Anthony joined Sovereign Health in May 1999 as General Manager of Finance and was subsequently appointed as Financial Director in 2001. Sovereign Health was acquired by the Momentum Group in 2005 at which time he became Chief Financial Officer of Momentum’s Group Benefit business cluster.

In January 2007, Anthony relocated to Mauritius to establish a health insurance business for Momentum. In this capacity, Anthony gained significant operational experience in the administration of health insurance plans and risk management. In October 2010 he joined Medscheme as Managing Director of both the Groups Mauritian operation (Administrators and Consultants Ltd) as well as the groups International business based in Mauritius.

In his current role, Anthony is responsible for driving the group’s strategy to diversify the business into new markets.

Head of International Business – Asia, Australasia & USA

Holds a MA, MBA degree with specialization in Finance, from university of Madras and national institute of management studies. Also a Certified Financial Planner with industry experience of over 9 years. Prabhu has rich Marketing & business development, project management, strategic planning experience coupled with investments and corporate finance deep knowledge and understanding. He is also a member of prestigious professional associations, CII (UK)and CFA institute member. Currently he is pursuing his law degree from University of London (Exterior).

At Medscheme he is responsible for international business development and market research for the following regions Asia, Australasia, United States. He is designated to champion and support new market entry and group strategy of Medscheme. His core international business activity is health care & insurance KPO new business acquisition and business retention. Prabhu is also executive management committee member for Medscheme international.

Our values

“Mutual Respect”

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Health care administration

Health BPO

Revenue Cycle management

solution

Claim Administration

Billing & coding

services

Data capture & processing

Insurance verification

Claims audit

Health risk management

solutions

International Health Outsourcing Services

“Innovation”

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Medscheme Health TPA Service

Client record management

Contribution /premium management

Claims management(assessing)

Client services (call center)

Retention (out bound call center)

Data and information Management

Fund Management

Financial Management

Key accounts (pay point client services)

Client walk in services

Sales and Marketing

Commissions Management

Provider claims and queries management

Fraud control & Audit

Business & Market intelligence

E- commerce

“quality service”

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BP

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Claim processing

Data image processing and capture

Intelligence claim edit

Claim screening and negotiating

Claim auditing

HIPAA standards management

Revenue cycle Management

Data entry & Data conversion

Data verification

Re –pricing and negotiation

Provider contract interpretation

Benefits validation

High risk claim review

Online updating

Mailroom service

Intelligence queue/data cleansing

Data mining and reporting

Case management

HEALTH INSURANCE CLAIM PROCESSING

“Innovation”

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Hospital utilization management

Managed oncology program

Wellness program

Counseling of high claimers

Chronic medication management

Managed radiology program

Managed dental program

Managed pathology program

Alternative fee structure / re-imbursement

Disease management

Health risk assessment

Specialists and GP networks

Technology services and electronic medicine management

MHRS – Medscheme Health Risk Solution

“Innovation”

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Ben

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Hospital Benefit

Management

Oncology Benefit

Management

Optical Benefit Management

Dental Benefit Management

HIV/AIDS Management

Benefit Management Cluster

“Innovation”

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Mauritius Key Facts : Favorable Outsourcing Climate

GMT+4 hoursDutch colony; French colony; English colony; independence 1968Constitution based on Westminster Parliamentary modelPolitical stability; multi-party system – elections every 5 yearsOfficial language is English, but French & Creole mostly used Population of 1.28 millionFreedom of religion; Hindu majority (65%)29.2% of workforce below 30 yearsFavorable tax regime (15%flat rate) – 3% for international co’s34 attractive double taxation agreementsFree economy, no currency controlExcellent connectivity – SAFE cableLow cost, well qualified workforce

“Innovation”

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Who can benefit from our services?

Third party AdministratorsInsurance CompaniesMedical Billing CompaniesManaged care organizationsGovernment organizationsPrivate PracticeHospitalsPharmacies Pharmacy Benefit Management companies

“Quality”

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Few names from our Valued client list

South Africa

“Innovation”

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Quality Business Back up

Disaster Recovery SiteFully operational offsite data centre & disaster recovery site at La Tour Koenig2 hour recovery delayDaily data backup stored off-siteTested 3 times per annum

Power redundancyUPSGenerator power

Connectivity redundancy1 Mb Nomad backup line

“Innovation”

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Quality

Quality Management System - ISO 9001:2008 accreditation

HIPAA Compliance

SAS 70 certified

Process Improvement - Six Sigma

Our Values

“Accountability”

LeadershipMISSION

STATEMENT

We create access to sustainable,

affordable, quality healthcare through the application of

innovation and expertise, delivered

as an efficient, seamless experience

Medscheme International

Port Louis

MT line MT line

BT MPLS IS MPLS

Nomad VPN backup

Nomad VPN backup

Connectivity

Client organisation

“Innovation”

Tec

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Full implementation of international best

practice

Proven hardware and software optimised to

deliver optimum benefits to both clients and the

company.

Salient facts: •Total data storage capacity 256 TB.

•Hardware partners are EMC, CICSO, AVAYA and UNISYS.

•95% of software supplied by Oracle, Novell Linux and Microsoft.

•Proven SAP integration to clients and healthcare providers

•Data in Disaster Recovery environment is on average 15 seconds behind our Production data.

•One of the first companies globally to implement Oracle technologies to achieve operational storage efficiencies, using tiered storage on Oracle 11G.

•All databases are running the latest version of Oracle 11G Release 2 - another first in the industry.

World-class technology and communications

“Speed & System Excellence”

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Hospital management

Medicine management

Disease management

Provider management

Aid for Aids

Nexus IT

“Profitability &

Performance ”

MEDSCHEME NUMBERS

Key Financial Information

Road Traffic Accident Fund

Irish Health Insurers

Managed Care

Audited 16 months

2010€’000s

Audited 12 months

2009€’000s

Audited 12 months

2008€’000s

Audited 12 months

2007€’000s

Revenue 146,699 78,943 88,606 101,204

Profit before taxation 16,227 7,934 6,261 11,932

“Innovation”

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Your outsourcing Benefits

minimize operations cost and maximize revenue. Example : Relief from employee expenses ,benefits and facility expenses.

Access to specialized service which are not your core expertise functionsOn time service deliveryYour valuable resource can focus on core competenciesGreat saving on infrastructure , software and technology cost Your business never sleeps. ( time zone benefit)Your business can handle any volumes because you have Medscheme international – “the Health Expert” can help you to address your growing business needs. Upto 40 % reduction on your business operations cost

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Irish Health Insurers

Managed Care

Our vision

“Creating a world of sustainable

healthcare”

Request Quote :Send your detailed project outsourcing requirement to prabhum@medschemeinternational.com , if you wish to talk to our project team kindly reach @ +230 4231666 .

Contact us

Medscheme International1st floor , Tower A1Cyber city Ebene , Mauritius

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THANK YOUFund

Irish Health Insurers

Managed Care

Our vision

“Creating a world of sustainable

healthcare”