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Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Fund management expertise nationwide – and unique to you

23 June 2022 ER24

ER24 is a preferred service provider in the field of emergency medical services and fund management countrywide. ER24 operates from 59 bases throughout South Africa and provides quality emergency response and pre-hospital care services, supporting both public and private hospitals.

R24 has more than 700 emergency personnel and more than 300 emergency vehicles. We have three Emergency Contact Centres that are available 24/7 and field 50 000 emergency calls per month. Our dedicated fund management team consists of qualified nursing practitioners experienced in Emergency Medical Services (EMS) and trauma, and staff with extensive scheme administration experience. We believe this provides a perfect balance of clinical and administrative expertise to ensure compliance with the rules of our schemes and the optimal management of the EMS risk. We provide customised services, risk mitigation, and case management solutions to various medical schemes, healthcare insurances and other funders in the healthcare industry. We pride ourselves on having the best team possible to provide a unique, quality service to our clients. We also prioritise identifying fraud, waste, and abuse timeously, notifying our clients of potentially high cost and high-risk cases. Tailor-made reports help our clients understand how their scheme is utilised and ensures that they are kept up to date on industry trends, enabling the proactive mitigation of financial loss. 

We recognise that our clients have different needs, and we strive to meet these specific requirements. We have designed four specific products with this in mind:

  • Access Agreement: provides members access to the ER24 Contact Centre, which includes emergency response and dispatch of emergency vehicles, including management of inter-facility transfers and aeromedical transport. This agreement also gives access to telephonic trauma counselling. All claims are submitted directly to the Scheme / Administrator for adjudication and payment.
  • Access Enhanced Agreement: provides access to all Contact Centre services and includes claims and fund management services. All claims are assessed, audited and submitted electronically to the Scheme / Administrator for payment with a payment recommendation.
  • Access Enhanced Plus Agreement: this provides all Contact Centre services and claims and fund management services. Under this agreement, the Scheme will provide ER24 with an agreed monthly pool to pay all provider claims. The Scheme retains the risk without the disadvantage of having to load all providers. A monthly reconciliation will be provided to the Scheme. Any shortfall will be invoiced to the Scheme on a monthly basis.
  • Risk Transfer Agreement: providing all services as above with claims paid from a risk pool at no further risk to the Scheme. 

We believe we offer a comprehensive bouquet of services customised to each client’s specific needs. For expert fund management, become an ER24 client today. Visit www.er24.co.za

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