Health Risk ManagementPrivate Health Administrators performs a full spectrum of administrative and managed healthcare functions on behalf of  the schemes utilising our platform and service. This is performed by committed, experienced and well trained staff, of whom the majority are registered nurses. Our processes are regularly reviewed and amended in accordance with the requirements of our clients.

Our service offering is comprehensive, and includes

  • New Business and Membership Management
  • Contributions Management
  • Claims Management
  • Contact Centre Management
  • Financial Administration
  • Statutory Reporting
  • Member and Provider Communication
  • Website administration and interactive functionality
  • Mobile application functionality

We also provide the following scheme Financial Management Solutions

  • Monthly Management Accounts
  • Budgeting and Treasury
  • Claims forecasting and utilisation review
  • Reporting, both on-demand and scheduled
  • Audit facilitation
  • CMS returns
  • SRM reporting
  • Debtors and premium control
  • Debts recovery
  • Scheme secretarial services and record keeping
  • Rules and policy drafting
  • Forensic and Clinical Audits
  • Corporate Governance and Internal Risk Control
  • Adhoc requests

Medical scheme administration is a complex environment involving high volumes of transactional data. The ability to provide a robust reliable technology solution, which operates accurately and efficiently, sits at the core to our offering.

PHA Admin

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