1. MedschemeInternationalPresentationMauritius2/6/20121

2. Medscheme Our visionCreating a world of sustainable www.medscheme.co.za www.medschemeinternational.com healthcare 3. Proven 40-year track record of leadership in Southern Africa. Largest managed care provider and third largest healthcare administrator in Southern Africa.IntroductionMedscheme 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.Our values 2 800 employees.IntegrityInternational BPO operation in Mauritius 4. Medscheme Mauritius Established in Mauritius in 1982 Medscheme acquired 30% stake in 2001; 100% stake in Oct 2010International BPO 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 boxOur values Work on client systems via CitrixIntegrity 5. Medscheme Mauritius and Medscheme Internationalis a 100% subsidiary of Medscheme holdings (south Africa)A member of JSE listed Afro centric group. Our visionCreating a world Medscheme Holdings of sustainable healthcare MedschemeMedscheme Mauritius InternationalMauritian domestic market International BPO contracts 6. Medscheme operational Divisions Our visionCreating a world of sustainable healthcare Our ValuesEmpowerment 7. Andr Meyer - Chief Executive OfficerLeadershipAndr joined Alexander Forbes Financial Services in 1987 as a Retirement FundConsultant and subsequently transferred to Durban, where he headed the local MISSIONNegotiated Benefits Unit for the company.STATEMENT He was appointed Divisional Director in 1991 and in 1997 was transferred to theHealth Care Consultants Division as Deputy Managing Director later becoming jointManaging Director responsible for the Health Management Solutions and the We create access toCommunications Division of Alexander Forbes. He also represented Alexander Forbeson the Board of FIHRST Management Services.sustainable,In April 2003, Andr was appointed as Medschemes CEO and, supported by theaffordable, quality Executive and management teams steered the Group through the successfulturnaround strategy and acquisition process.healthcare through the application ofLee Callakoppen - Executive Director: Human Capitalinnovation andLee obtained a degree in Information Science from the Rand Afrikaans University in expertise, delivered 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 as an efficient, an LLB degree. seamless experienceHe began his career in operational management in the retail sector and later movedinto Human Capital, holding positions in various industries ranging from retail totelecoms to media. Lee held the position of HR Executive for the Primedia ContentDivision before joining Medscheme in 2007.As Executive Director, Human Capital, he is responsible for the continued Our Values implementation of Lethimvula Healthcares strategy to become an employer ofchoice.Accountability 8. Anthony Pedersen Managing Director: Medscheme InternationalAnthony is a qualified Chartered Accountant having completed a Bachelor ofCommerce and an Honours Bachelor of Accounting Science. He completed hisLeadershiptraining at Arthur Andersen and is a member of both the South African Instituteof Chartered Accountants and the New Zealand Institute of Chartered MISSIONAccountants.After a short time as Head of Internal Audit in the retail sector, Anthony joinedSTATEMENT Sovereign Health in May 1999 as General Manager of Finance and wassubsequently appointed as Financial Director in 2001. Sovereign Health wasacquired by the Momentum Group in 2005 at which time he became Chief We create access toFinancial Officer of Momentums Group Benefit business cluster. In January 2007, Anthony relocated to Mauritius to establish a health insurancesustainable,business for Momentum. In this capacity, Anthony gained significant operationalexperience in the administration of health insurance plans and risk management.affordable, quality In October 2010 he joined Medscheme as Managing Director of both the GroupsMauritian operation (Administrators and Consultants Ltd) as well as the groupshealthcare throughInternational business based in Mauritius.In his current role, Anthony is responsible for driving the groups strategy to the application of diversify the business into new markets.innovation andHead of International Business Asia, Australasia & USA expertise, delivered Holds a MA, MBA degree with specialization in Finance, from university ofMadras and national institute of management studies. Also a Certified Financial as an efficient, Planner with industry experience of over 9 years. Prabhu has rich Marketing &business development, project management, strategic planning experience seamless experiencecoupled with investments and corporate finance deep knowledge andunderstanding. He is also a member of prestigious professional associations, CII(UK)and CFA institute member. Currently he is pursuing his law degree fromUniversity of London (Exterior).At Medscheme he is responsible for international business development and Our Values market research for the following regions Asia, Australasia, United States. He isdesignated to champion and support new market entry and group strategy ofMedscheme. His core international business activity is health care & insuranceAccountabilityKPO new business acquisition and business retention. Prabhu is also executivemanagement committee member for Medscheme international. 9. Medscheme InternationalServicesInternational Health Outsourcing Services Our valuesMutual Respect 10. Medscheme Health TPA ServiceClient record managementContribution /premium managementHealth Administrative serviceClaims management(assessing)Client services (call center)Retention (out bound call center)Data and information Management offeringFund ManagementFinancial ManagementKey accounts (pay point client services)Client walk in servicesSales and MarketingCommissions ManagementProvider claims and queries managementFraud control & AuditInnovationBusiness & Market intelligenceE- commerce 11. HEALTH INSURANCE CLAIM PROCESSINGClaim processingData image processing and captureMedscheme InternationalIntelligence claim editClaim screening and negotiatingClaim auditing BPO serviceHIPAA standards managementRevenue cycle ManagementData entry & Data conversionData verificationRe pricing and negotiationProvider contract interpretationBenefits validationHigh risk claim reviewOnline updatingMailroom serviceIntelligence queue/data cleansingquality service Data mining and reportingCase management 12. MHRS Medscheme Health Risk SolutionHealth Risk & Managed Care Hospital utilization management Managed oncology program Wellness program Counseling of high claimers Expertise 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 managementInnovation 13. Benefit Management Cluster Health Benefit Management HospitalOptical BenefitHIV/AIDS BenefitManagementManagement Management OncologyDental BenefitBenefitManagementManagementInnovation 14. Mauritius Key Facts : FavorableOutsourcing Climate GMT+4 hours Dutch colony; French colony; English colony; independence 1968 Mauritius Facts Constitution based on Westminster Parliamentary model Political stability; multi-party system elections every 5 years Official language is English, but French & Creole mostly used Population of 1.28 million Freedom of religion; Hindu majority (65%) 29.2% of workforce below 30 years Favorable tax regime (15%flat rate) 3% for international cos 34 attractive double taxation agreements Free economy, no currency controlInnovation Excellent connectivity SAFE cable Low cost, well qualified workforce 15. Who can benefit from our services?Medscheme InternationalThird party AdministratorsWho can benefit ?Insurance CompaniesMedical Billing CompaniesManaged care organizationsGovernment organizationsPrivate PracticeHospitalsPharmaciesPharmacy Benefit Management companiesInnovation 16. Few names from our Valued client listMedscheme International Our clientsQualitySouth Africa 17. Quality Business Back upDisaster Recovery SiteMedscheme InternationalFully operational offsite data centre & disaster recovery Disaster Recovery site site at La Tour Koenig 2 hour recovery delay Daily data backup stored off-site Tested 3 times per annumPower redundancy UPS Generator powerConnectivity redundancy 1 Mb Nomad backup lineInnovation 18. QualityMedscheme InternationalQuality Management System - ISO 9001:2008accreditationQuality @HIPAA ComplianceSAS 70 certifiedProcess Improvement - Six SigmaInnovation 19. ConnectivityLeadership MISSION MedschemeSTATEMENT Nomad VPNNomad VPNInternationalbackup We create access tobackupsustainable,affordable, quality MT lineMT linehealthcare through the application ofinnovation and expertise, delivered BT MPLS IS MPLS as an efficient,ClientPort Louisorganisation seamless experience Our ValuesAccountability 20. World-class technology and communicationsSalient facts:TechnologyTotal 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 clientsProven hardware andand healthcare providers Full implementation of Data in Disaster Recoverysoftware optimised to deliverinternational best environment is on average 15optimum benefits to bothpractice seconds behind our Productionclients and the company. 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.Innovation 21. NEXUS IT World classHealth Technology HospitalAid for AidsmanagementProviderNexus ITMedicine managementmanagementDiseasemanagementSpeed & SystemExcellence 22. Key Financial Information Audited 16 Audited 12 Audited 12 Audited 12months months months months MEDSCHEME2010 2009 2008 Irish Health2007 000s 000s 000s 000sNUMBERSInsurers Managed Care Revenue146,699 78,943 88,606 101,204 Road Traffic Profit before taxation Accident Fund 16,2277,9346,261 11,932Profitability&Performance 23. Your outsourcing BenefitsMedscheme International Benefit of outsourcingminimize operations cost and maximize revenue. Example : Relief from employee expenses ,benefits and facility expenses.Access to specialized service which are not your coreexpertise functionsOn time service deliveryYour valuable resource can focus on core competenciesGreat saving on infrastructure , software andtechnology costYour business never sleeps. ( time zone benefit)Your business can handle any volumes because youhave Medscheme international the Health Expertcan help you to address your growing business needs. Upto 40 % reduction on your business operations costInnovation 24. Contact us MEDSCHEME Medscheme International 1st floor , Tower A 1Cyber city Ebene , Mauritius Irish Health Request Quote : Insurers Send your detailed project outsourcing requirement toManaged prabhum@medschemeinternational.com , Care if you wish to talk to our project team kindly reach @ +230 4231666 . Our visionCreating a world of sustainable healthcare 25. MEDSCHEME Irish Health Insurers Managed Care THANK Our vision YOUFundCreating a world of sustainable healthcare