MTC MY TREATMENT CARD HR TOOL Member Card Panel Clinic Sticker A - - PowerPoint PPT Presentation

MTC

MY TREATMENT CARD

HR TOOL

Member Card

Panel Clinic Sticker

MEMBER PORTAL  HR PORTAL



PANEL CLINIC  A Third Party Administrator (TPA)

Panel Clinic Portal Online Real Time System – EDC/WEB ACCESS

• Secured and trusted health card
• Electronic online eligibility verification and real-time confirmation of benefits.
• Data processing is fast, accurate and secure.
• Can be customized to meet your every need.
• Delivering the highest standard of service

“On-line Real-time Mode” 24 Hours / day, 7 days / week

Automated Electronic Process to GP Clinics

• 1. Registration
• 4. Submission
• 2. Verification
• 3. Valid Member

proceed to seek cashless medical treatment.

Date & Time Merchant ID Terminal ID: Card No: Card Type: PAY Medilink Test Card 000000-00-0000 Medilink 27-JAN-2013 09.11 Diag: xxxx/xxxx MC: x days Total Billing: RM Total Approved: RM Patient to Pay: RM Sign: ............................... ***Nothing Follows*** Date & Time Merchant ID Terminal ID: Batch No: Card No: Card Type: INQ Medilink Test Card 000000-00-0000 Medilink 27-JAN-2013 09.11 Confirmed Valid Member ***Nothing Follows***

...in 15 seconds...

Automated Electronic Process

***Nothing Follows***

Eligibility Verification:

• 1. Card Validity
• 2. Limit Verification
• 3. Panel Provider Verification
• 4. Check Exclusion

HR Portal

***Nothing Follows***

• 1. New Employees / Dependents online registration.
• 2. Online Employees / Dependents card deactivation.
• 3. Panel clinic listing.
• 4. Reports.

Standard Reports Availability through HR Portal

Frequently - Daily, Monthly and Annually Sample Standard Reports: 1.Detailed Claim Transactions Data

Report Name ANALYSIS OF MEMBERS VISITATION TO GP CLINICS AND VISIT DATE Payor Corporate From 01 April 2012 To 30 April 2012 Report Date 25 May 2012 Report Type Monthlyv

Employee Name Abdul Aziz B. Abdul Rahim Abdullah Bin Mohd Yusof Afzart Feizaireey Bin Abdul Ghani Staff ID 011458 036793 046670 Visit Date 06 April 2012 09:44:44pm 10 April 2012 11:35:08pm 29 April 2012 11:10:24pm Patient Name Abdul Aziz B. Abdul Rahim Abdullah Bin Mohd Yusof Afzart Feizaireey Bin Abdul Ghani Diagnosis Other Gastroenteritis and Colitis Injury of Unspecified Body Region Asthma Provider Name Kumpulan Medic - Menara Boustead Klinik Ng Dan Lee - Pudu Klinik Ng Dan Lee - Pudu Amount 27.00 85.00 73.00 Claim No. 47614 47849 49103

Analysis of Utilization by Age Group

Report Name ANALYSIS OF UTILIZATION BY AGE GROUP Payor Corporate From 01 April 2012 To 30 April 2012 Report Date 24 May 2012 Report Type Monthly

Avg Cost Per Visit E = C / B 0.00 42.50 42.08 42.90 56.99 69.00 46.41 Age 0 -10 11 - 20 21 - 30 31 - 40 41 - 50 51 - 60 Total

• No. Of Life

A 1 19 186 115 77 28 426

• No. Of Visit

B 6 77 42 37 5 167 Total Cost C 0.00 255.00 3,240.40 1,802.00 2,108.50 345.00 7,750.90 Avg Cost Per Life D = C / A 0.00 13.42 17.42 15.67 27.38 12.32 18.19

Analysis of Utilization by Medical Diagnosis

Report Name ANALYSIS OF UTILIZATION BY MEDICAL DIAGNOSIS Payor Corporate From 01 April 2012 To 30 April 2012 Report Date 25 May 2012 Report Type Monthly

Medical Dianogsis R50 - Fever of Other and Unknown Origin T14.0 - Superfical Injury of Unspecified Body Region 463 - Acute Tonsillitis 558 - Other Gastroenteritis an Colitis M25.5 - Pain in Joint G43 - Migraine M54 - Backache T78.4 - Allergy; Unspecified J06 - Acute Upper Respiratory Infections 379 - Other Disorders of Eye N30 - Cystitis (Urinary Tract Infection) T14 - Injury of Unspecified Body Region V01 - Motor Vehicle Accident R10 - Abdominal and Pelvic Pain I10 - Essential (Primary) Hypertension E11 - Non Insulin Dependent Diabeted Mellitus (NIDDM)

• No. Of Visit

A 36 23 15 15 12 11 8 5 4 4 3 3 3 3 2 2 Total Cost B 1,632.40 785.00 828.00 557.00 500.50 414.00 372.00 258.00 175.00 175.00 223.00 170.00 129.00 120.00 300.00 275.00 Avg Cost Per Visit C = B / A 45.34 34.13 55.24 37.13 41.71 37.64 46.50 51.60 43.75 43.75 74.33 56.67 43.00 40.00 150.00 137.50

Most Highly Utilized Healthcare Providers

Report Name MOST HIGHLY UTILIZED HEALTHCARE PROVIDERS Payor Corporate From 01 April 2012 To 30 April 2012 Report Date 25 May 2012 Report Type Monthly

Avg Cost Per Visit C = B / A 44.41 46.55 60.21 51.36 36.71 45.91 45.17 45.70 42.00 65.00 Healthcare Provider Poliklinik Bandar Kumpulan Medic - Menara Boustead Reddy Clinic - Jalan Ipoh Klinik Ng Dan Lee - Pudu Klinik Mediviron - Pandan Indah Klinik Ng Dan Lee - Ampang Klinik Anda Poliklinik Central & Surgeri - Gombak Klinik Ng Dan Lee - Wangsa Maju Klinik V-Cure Sdn Bhd

• No. Of Visit

A 87 21 14 13 7 7 6 6 5 1 Total Cost B 3,864.00 977.60 843.00 667.70 257.00 321.40 271.00 274.20 210.00 65.00

Analysis of Medical Leave Granted by Provider

Report Name MOST HIGHLY UTILIZED HEALTHCARE PROVIDERS Payor Corporate From 01 April 2012 To 30 April 2012 Report Date 25 May 2012 Report Type Monthly

Provider Name Poliklinik Bandar Klinik Ng Dan Lee - Ampang Kumpulan Medic - Menara Boustead Klinik Ng Dan Lee - Wangsa Maju Klinik Ng Dan Lee - Pudu Klinik Mediviron - Pandan Indah Poliklinik Central & Surgeri - Gombak Klinik Anda Klinik Clinic - Jalan Ipoh Klinik V-Cure Sdn Bhd Klinik Anis - Shah Alam Klinik Bandaraya Klinik Medik 24-7 - Bandar Country Homes Klinik One Medic Klinik Prime Care - Bali Klinik Rashid & Rakan-rakan Kumpulan Medic - Jalan Ampang

• No. Of Visit

87 7 21 5 13 7 6 6 14 1 Total MC Given 48 10 8 6 5 5 5 4 2 Avg MC Per Visit 0.55 1.43 0.38 1.20 0.38 0.71 0.83 0.67 0.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total 167 93 0.56

Member Interactive Portal

Welcome, member! Member Login Login Id Password Remember me on this computer Sign In

New Member Registration

Member Portal

Phone Apps and Web Access. Employees are able to access the following:

• Search for panels clinics.
• Check utilization and balance.
• View and print their Clinic Visit Track Records.
• Get Health Tips.
• Interact with Call Centre via I-Chat.

Advantages of Using MTC Online System

CARD FEE:

• 1. Initial Card – No Cost .
• 2. Subsequent cards – No Cost.
• 3. Replacement Card – No Cost.

Note : Cards are sponsored by Rayyan Medical Services. MEMBER PORTAL - Phone Apps and Web Access.

• 1. Easy access for employees to identify their panel

clinics and keep track of their utilization.

• 2. HR’s are relieved from the hassle of employees

referring to them on panel clinics and utilization

Advantages of MTC ONLINE SYSTEM

SYSTEMS

• Able to set alerts – monitoring of MC and utilization.
• Can create own customized reports.
• Can set exclusion list – non covered benefits
• Can set number of visits – per day/per week.
• Can set clinics by employees – selected clinics

MEDICAL MANAGEMENT

• Prepare utilization statistic and analysis.
• Periodical review of utilization and recommendation.
• Co-ordinate with clinics on MC issuance and charges.
• Organize Health Campaigns.
• Organize Health Talks.

Comparison with Current System

OTHERS TPA

• 1. CARDS

New Cards - RM 5 Replacement Cards – RM 10

• 2. MEMBER PORTAL – NO
• 3. REPORTS

Limited Reports. Excel Download – need to sort. Can’t create customize report.

• 4. Coverage – GP only
• 5. SYSTEM ALERTS - NO

MY TREATMENT CARD

• 1. CARDS

New Card – no charge Replacement Cards – No charges

• 2. MEMBER PORTAL – YES
• 3. REPORTS

Unlimited Reports. Excel Download – No sorting required. Able to customize own reports.

• 4. Coverage – Comprehensive: GP,

Specialist and Hospitalization.

• 5. SYSTEM ALERTS - YES