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Products and Services
Medical Aid Fund Administration
- Client Relationship Management
AFA offers Client Relationship Management through its different departments. The role of AFA in this regard is to ensure that the administered schemes members’ and government ART beneficiaries understand their benefits entitlements and the rules applied, while at the same time facilitating the processing and payment of healthcare claims. This function is also concerned with the registration of service providers and relationship building between the schemes/ government and service providers as a way of ensuring that beneficiaries receive excellent service. AFA customer service, in relative terms, is considered to be the best in the medical aid industry, thus giving its administered schemes a competitive edge in the market.
In a nutshell, this important function ensures that the administered schemes stay ahead in medical aid services and facilitation of provision of high standard healthcare to scheme members by service providers.
- Optimising Medical Aid Spend
As a medical aid administrator, AFA also plays a central role in ensuring the efficient spending of each healthcare Pula (BWP) received. Intelligence gathered from, and through the member groups; and healthcare associations’ activities enable AFA to develop and implement initiatives that address specific categories of healthcare spend.
- Growing and Retention of Membership
AFA markets and promotes the schemes and their products & services to increase awareness which facilitates membership growth and retention. Such awareness is achieved through the development and implementation of communication strategies that are relevant to the target market. The target market is continuously broadened through the identifications of gaps in the market and subsequent proposals to schemes to create and introduce more products and services to diversify their business.
- Corporate Secretarial Services
The company also provides corporate secretarial services to its clients. This includes timely logistical and administrative support for ad-hoc or routine and annual general meetings, production and distribution of minutes, maintenance of the statutory records and ensuring compliance with corporate governance standards.
- Finance and Accounting Services
AFA provides financial and accounting services to its clients. The company ensures proper financial planning and management of Schemes’ activities, in accordance with statutory and best practice requirements. These includes, amongst others; production of financial plans (i.e. budgets, cashflow forecasts), collection of subscriptions, preparation of the management accounts, financial statements investment of surplus funds and investment proposals, payment of invoices and medical claims and resolutions of queries relating to payments.
Managed Care
- Disease Management
Effective case management, at an individual beneficiary level, leverages off the on-going managed care initiatives, and is elevated to the level of integrated care by AFA’s disease management programmes. The success of this area of AFA’s business is facilitated by the Managed Care Programme. This programme uses a customer and cost-effective centralized treatment authorization model which is responsible for the clinical and financial management of chronic diseases, including HIV/AIDS and related conditions.
The ability to measure the outcome of product application provides AFA with the information to continually enhance and expand its products profile.
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