Service Offering

MSO has a strategy of focusing only on what it does best. The product offering is tightly focussed on Hospital Risk, Disease and Specialist Benefit Management. The product includes all activities where it is possible to deliver savings greater than the service cost. MSO offers a single point of contact service on a sophisticated call centre technology platform through which we can route calls through to any other service provider and also allows for toll-free international dialing into the call centre. The service operates 24 hours and 7 days a week, including public holidays. The call centre service currently offers services in English, French, Arabic, and Portuguese. Our consultants are all clinical qualified and are trained in assisting members or service providers with member validation, service provider/ facility queries, member benefit queries, assist with pre-authorisation, issuing letters of guarantee or verification of benefits, coordination of medical assistance and emergency evacuation cases. The contact centre service also offers access to a dedicated 24/7 monitored client e-mail service.

The product offering includes:

The product can be expanded to cover any area or procedure that client rules require to be pre-authorised or case managed. As an additional service, MSO can act as an intermediary for the client with third party providers that cover the full spectrum of managed care, including HIV/AIDS management, emergency facilitation and GP network management. For each area, an accredited supplier has been identified that the MSO can confidently associate with, without risk to its brand or reputation. The approach provides the client with a ‘one-stop service’ for all its managed care needs.

Medical Peer Review / Second Opinion

MSO offers a service known as a Second Opinion/ Medical Peer Review. Essentially this service entails a review of hospital requests by an Independent Medical Specialist, either through setting up a member consultation or by a review of medical reports and suggested treatment options. MSO offers this service to its clients by providing access to a variety of Medical Specialists in almost every medical specialty, including dental. These professionals have been selected based on their ability to provide accurate, credible and defensible opinions on appropriate treatment, identify pre-existing condition. Many of the Professionals that are included in MSO’s review process are highly regarded individuals currently practicing within a clinical setting and/ or involved with South Africa’s leading medical schools and Academic hospitals. The key benefit of this service in managing your risk is the value of a highly defensible opinion, when one is required to make a funding decision on cover for appropriate medical care/ treatment.

Provider Network Service

MSO has entered into strategic partnerships with several national & international partners directly or through our subsidiary company MSO International which gives MSO the ability to negotiate rates with service providers within our network of service providers composed of physicians, hospitals, or other providers which offer health care services. The key benefit of this service element ensures that there is virtually no administrative burden or threat of balance billing the member or requirement for upfront payments by members. Additional benefits of this service include the availability of multiple service networks affording members some degree of choice in terms of services or facilities within the Network, and preferential rates or the ability to negotiate discounts. Currently MSO has access to more than 6,000 directly contracted facilities within the network, including hospitals, physicians and other healthcare service providers. MSO International has the ability to offer you an option of access to a wide Network or a more exclusive custom Network of service providers.