Medscheme Overhauls Claims System for Better Strategies

Client: Medscheme, South African healthcare administrator and health risk management company.

Challenge: Update its existing claims management capabilities and improve the agility, efficiency and effectiveness of the system to respond quickly and easily to market, competitor, policy, strategy or regulatory change.

Solution: FICO® Blaze Advisor® decision rules management system.

Results: By empowering the business with more agile business rules, Medscheme has market-leading claims management capabilities that make it easier and quicker to adapt to the requirements of client schemes to manage the costs of healthcare.