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UMS Hospital Benefit Management System

UMS is a Hospital Benefit Management system that makes it easy for healthcare businesses to manage the administrative processes involved in managing medical schemes’ hospital benefits. Requests for authorisation through to the assessment, authorisation and payment of hospital claims are processed by applying business rule logic designed to formalise decision-making in line with clinical and contractual policies.

The key features of the application include:

  • Pre-Authorisations
  • Case Management
  • Member Management
  • Scheme Rules And Policies
  • Provider Management
  • Clinical Code Rules
  • Hospital Contracting
  • Hospital Claims Re-Pricing

Find out more about our other products,Nexus and AFA.