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

A Third Party Administrator (TPA) PANEL CLINIC  MEMBER PORTAL   HR PORTAL

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 Date & Time Merchant ID 1. Registration 2. Verification Terminal ID: Batch No: ...in 15 seconds... Card No: Card Type: INQ Medilink Test Card Date & Time 000000-00-0000 Merchant ID Medilink Terminal ID: 27-JAN-2013 09.11 Card No: Confirmed Valid Member Card Type: ***Nothing Follows*** PAY Medilink Test Card 000000-00-0000 4. Submission 3. Valid Member Medilink proceed to seek 27-JAN-2013 09.11 cashless medical Diag: xxxx/xxxx MC: x days treatment. Total Billing: RM Total Approved: RM Patient to Pay: RM Sign: ............................... ***Nothing Follows***

Automated Electronic Process Eligibility Verification: 1. Card Validity 2. Limit Verification 3. Panel Provider Verification 4. Check Exclusion ***Nothing Follows***

HR Portal 1. New Employees / Dependents online registration. 2. Online Employees / Dependents card deactivation. 3. Panel clinic listing. 4. Reports. ***Nothing Follows***

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

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 Age No. Of Life No. Of Visit Total Cost Avg Cost Per Life Avg Cost Per Visit A B C D = C / A E = C / B 0 -10 1 0 0.00 0.00 0.00 11 - 20 19 6 255.00 13.42 42.50 21 - 30 186 77 3,240.40 17.42 42.08 31 - 40 115 42 1,802.00 15.67 42.90 27.38 41 - 50 77 37 2,108.50 56.99 51 - 60 28 5 345.00 12.32 69.00 Total 426 167 7,750.90 18.19 46.41

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 No. Of Visit Total Cost Avg Cost Per Visit A B C = B / A R50 - Fever of Other and Unknown Origin 36 1,632.40 45.34 T14.0 - Superfical Injury of Unspecified Body Region 23 785.00 34.13 463 - Acute Tonsillitis 15 828.00 55.24 558 - Other Gastroenteritis an Colitis 15 557.00 37.13 M25.5 - Pain in Joint 12 500.50 41.71 G43 - Migraine 11 414.00 37.64 M54 - Backache 8 372.00 46.50 T78.4 - Allergy; Unspecified 5 258.00 51.60 J06 - Acute Upper Respiratory Infections 4 175.00 43.75 379 - Other Disorders of Eye 4 175.00 43.75 N30 - Cystitis (Urinary Tract Infection) 3 223.00 74.33 T14 - Injury of Unspecified Body Region 3 170.00 56.67 V01 - Motor Vehicle Accident 3 129.00 43.00 R10 - Abdominal and Pelvic Pain 3 120.00 40.00 I10 - Essential (Primary) Hypertension 2 300.00 150.00 E11 - Non Insulin Dependent Diabeted Mellitus (NIDDM) 2 275.00 137.50

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 Healthcare Provider No. Of Visit Total Cost Avg Cost Per Visit A B C = B / A Poliklinik Bandar 87 3,864.00 44.41 Kumpulan Medic - Menara Boustead 21 977.60 46.55 Reddy Clinic - Jalan Ipoh 14 843.00 60.21 Klinik Ng Dan Lee - Pudu 13 667.70 51.36 Klinik Mediviron - Pandan Indah 7 257.00 36.71 Klinik Ng Dan Lee - Ampang 7 321.40 45.91 Klinik Anda 6 271.00 45.17 Poliklinik Central & Surgeri - Gombak 6 274.20 45.70 210.00 Klinik Ng Dan Lee - Wangsa Maju 5 42.00 Klinik V-Cure Sdn Bhd 1 65.00 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 No. Of Visit Total MC Given Avg MC Per Visit Poliklinik Bandar 87 48 0.55 Klinik Ng Dan Lee - Ampang 7 10 1.43 Kumpulan Medic - Menara Boustead 21 8 0.38 Klinik Ng Dan Lee - Wangsa Maju 5 6 1.20 Klinik Ng Dan Lee - Pudu 13 5 0.38 Klinik Mediviron - Pandan Indah 7 5 0.71 Poliklinik Central & Surgeri - Gombak 6 5 0.83 Klinik Anda 6 4 0.67 Klinik Clinic - Jalan Ipoh 14 2 0.14 Klinik V-Cure Sdn Bhd 1 0 0.00 Klinik Anis - Shah Alam 0 0 0.00 Klinik Bandaraya 0 0 0.00 Klinik Medik 24-7 - Bandar Country Homes 0 0 0.00 Klinik One Medic 0 0 0.00 Klinik Prime Care - Bali 0 0 0.00 Klinik Rashid & Rakan-rakan 0 0 0.00 Kumpulan Medic - Jalan Ampang 0 0 0.00 Total 167 93 0.56

Member Interactive Portal Welcome, member! Member Login Login Id Password Remember me on this computer Sign In Forgot My Password * Reminder: You should never reveal your PIN and/or Password to anyone. 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 MY TREATMENT CARD 1. CARDS 1. CARDS New Cards - RM 5 New Card – no charge Replacement Cards – RM 10 Replacement Cards – No charges 2. MEMBER PORTAL – NO 2. MEMBER PORTAL – YES 3. REPORTS Limited Reports. 3. REPORTS Excel Download – need to sort. Unlimited Reports. Can’t create customize report. Excel Download – No sorting required. Able to customize own reports. 4. Coverage – GP only 4. Coverage – Comprehensive: GP, 5. SYSTEM ALERTS - NO Specialist and Hospitalization. 5. SYSTEM ALERTS - YES