Healthcare Scheme Administration

As a leading medical scheme, Capitated Fund Administrator or National Health Insurance administrator, are you running the solution of choice?

MIP's Healthcare Scheme Administration will address your robust administration requirements.


Our Healthcare system is designed to manage the administration of your new generation scheme, traditional medical scheme or National Health Insurance scheme. This includes savings accounts, thresholds, gap cover, capitation, network and fixed price contracts.

  • Cost savings
  • Transparency
  • Management control

The system's functionality enables you, as an outsourced administrator, to perform the required duties in a streamlined, cost-effective and efficient way.

By providing management information throughout the process, MIP Health Administration highlights your everyday processing blind spots, ensuring the smooth and reliable administration of all medical schemes processes.


We are the only provider to offer you full integration on a single platform across all elements.

• Contribution management
• Member management
• Claims and payment management
• Provider management
• New business, broker and agent management
• Scheme administration
• Work Flow
• Financial accounting
• Statutory reporting
• Managed Care administration (with the option of interfacing with MSO)
• Multimedia incorporating communications management and document scanning
• Disease management (via MSO)
• Hospital Utilisation management (with the option interfacing with MSO)
• Provider network management
• Capitation product management
• Call Centre
• Management Information systems and data warehousing


MIP Healthcare is a web-based system. This has many advantages including ease of access from remote sites or internal Intranet on an existing network, as well as ease of use where all pertinent data to service a member or provider is available on a single scrollable screen, rather than via a complex menu-structure. Faced with pressing social, economic, external, legislative, and technological factors driving change in the healthcare funding industry, as well as escalating customer expectations, emerging risk exposures, and new regulatory directives, administrators are increasingly looking to software engineering solutions to stay ahead.

MIP Healthcare offers a powerful solution to administrators and addresses a number of important needs:

•   The need for integration. MIP Healthcare is an integrated administration system, providing for member management, contribution management, claims processing, provider management, plan and service management, document management, eligibility management, agent and broker management, authorisation and case management all in one system. Full integration into MIP Financials, a powerful financial accounting system is also available.

•   The need for automated processes. MIP Healthcare avoids process duplication, automates period ends, batch runs and reporting, accepts electronic claims, authorisation, and financial data from a wide variety of third parties, and this contributes to a streamlined business process.

•   The need for organic growth and flexibility. MIP Healthcare makes it easier to grow the member base with its marketing support and broker sub-system. Being largely parameter driven, it is flexible enough to handle multiple schemes, options and commission structures. As the membership base grows or new plans are made available, MIP Healthcare will be reconfigured to handle the new demands.

•   The need for management information. Apart from a host of standard reports, MIP Healthcare incorporates a data warehouse subsystem that is used together with Business Intelligence tools to provide an overhead view of the business, and detailed analysis via drill downs and ad hoc reporting on both financial and clinical data. This information can be displayed in a variety of graphical and report formats.

•   The need to comply with future trends. MIP keeps MIP Healthcare up to date with industry, legislative and technological trends.

•   The need for access for members, providers and employers. MIP Healthcare allows for benefit reservations via the Internet and an active and secure website to enable authorised stakeholders to view and maintain data.


MIP Healthcare's architecture and design makes extensive use of user-defined parameters. This ensures more efficient, user-driven maintenance and therefore quicker resolution when system changes are required.


We're the leading provider of affordable Business/IT solutions to the financial services industry in emerging markets.


"Tomorrow's Solutions Enjoyed"


"MIP is a provider of robust, flexible, innovative, business/IT solutions that enable our partners to grow their customer bases profitably."

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