Our Solutions

PRODUCTS AND SERVICES

Medical Schemes Master

  • Medical Scheme Plan Option Tables
  • Claim Routing/ Switch Codes
  • Scheme Mark-Up Calculation Rules
  • Tariff rates linked on Option level
  • Co-Payments Advisory Information
  • Acute and CDL Formularies
  • Dispensing Rules and Remarks
  • Scheme Contacts Directory
  • Health Insurances
  • eHR and eScript Functions

Tariff Rates Master

  • 72 Healthcare Disciplines across 5 Medical Types
  • Medical Scheme Rates
  • GP Network Rates
  • Specialist Payment Arrangements
  • RCF Tariff Rates
  • Billing Unit Values and Types
  • Billing Modifiers
  • Custom Codes and Rates
  • COID Rates

Pharmaceuticals Master

  • NAPPI Code
  • Trade Name
  • Single Exit Price (SEP)
  • Active Ingredients
  • Generic Equivalent Code
  • Therapeutic Equivalent Code
  • Manufacturer List Price
  • ATC Drug Classification
  • CDL Indicator
  • Allergy Flags
  • Scheme Exclusion Criteria

Consumables Master

  • NAPPI Codes
  • List Price
  • Manufacturers
  • Product Classifications
  • Exclusions Criteria
  • Product Codes

Corporate Solutions

  • Comprehensive data sets to support Business Intelligence (BI) Reporting
  • Centralised in-house Masterfile to support Business Processes
  • Master Database architecture developed for seamless integration
  • Enables high quality, in depth data analysis across all NAPPI-coded products

Medprax Data Services

  • Maintain Core Product Datasets daily
  • Liaise with key industry stakeholders
  • Implement Data Integrity
  • Align South African drug sets with international coding & classification systems
  • Customise data outputs to meet client-specific needs

Radiology

  • Nappi Code
  • All Radiology Products listed
  • Radiology Supportive Medicines
  • Radiology Supportive Consumables
  • Single Exit Price (SEP)
  • Active Ingredient(s)
  • ATC Code Classification
  • Generic Equivalent Code

  • Therapeutic Equivalent Baskets

  • Manufacturer Name

Oncology

  • Nappi Code
  • Trade Name
  • Single Exit Price (SEP)
  • Medical Aid Reference Price
  • Active Ingredient(s)
  • ATC Code Classification
  • Generic Equivalent Code
  • Therapeutic Equivalent Baskets
  • Manufacturer Name
  • CDL Indicator
  • Allergy Flag(s)
  • Oncology Supportive Medicine Flag
  • Scheme Exclusion(s) Criteria
  • ICD-10 Code (PBM/CDL Mapping)

OUR DATA SILOS

Medical Schemes

187 Administrators
572 Schemes and destinations
1 276 Plans
1 668 Options
6 689 Sub-Options

Tarrif Rates

1 668 Scheme Options
Linking to:
72 Healthcare Disciplines
300 Price Groups

Pharmaceuticals & Consumables

1 200 Pharmaceutical Companies
2 000 Manufacturers (in SA alone)
250 000 Products

MEDPRAX CORE DATA PRODUCTS ARE USED BY VARIOUS CUSTOMER GROUPS

MEDPRAX IS BACKED WITH ESSENTIAL DATA

Medical Administrators and Schemes

0
Medical Scheme Plans
0
Scheme Options
0
Scheme Sub-Options
0
Healthcare Disciplines
0
Tariff Price Groups
0
Pharmaceutical Companies
0
Pharmaceutical Manufacturers
0
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PROVIDER SOLUTIONS

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CORPORATE SOLUTIONS

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PARTNER SOLUTIONS