MEDICINE CLAIMS PROCESSING AND CHRONIC MEDICATION PRE-AUTHORISATION

Compcare Wellness uses Mediscor as its Pharmaceutical Benefit Manager to perform real time electronic processing of its members medicine claims.

Mediscor can be contacted on the following numbers:

Switchboard     012 674 8000
ChroniLine   0860 119 553
Helpdesk  0860 113 238
Website  www.mediscor.net

Mediscor will verify the following when your Pharmacy submits an electronic claim:

  • That you are a valid member and have benefits available
  • That medicines excluded from benefits are not paid
  • That the price and dispensing fee is correct
  • That the levy/co-payment is correctly calculated

Simultaneously the Mediscor system ascertains whether:

  • The medicines on the prescription are compatible
  • The medicines can be taken together with other medicines that you may have received from another source
  • That you are not taking/receiving the same medicines under the same or a different name
  • That you have completed at least 80% of your current script/fill before allowing the pharmacist to dispense the new prescription

The benefits of the Mediscor system are:

  • All pharmacies in South Africa are electronically linked to Mediscor
  • It will ensure that you will not be supplied with medicines that are inappropriate for the condition or harmful when inter-acting with other medicines
  • It assists your medical aid to contain possible fraud and prevent issuing of unnecessary duplicated medicines