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Healthcare Companies

Medprax interfaces with these Practice Management Systems and many more

Icons for different practice management softwares
Administrators, Medical Schemes and managed companies

Administrators, Medical Schemes and Managed Care Companies

 

The Medprax database is extensively used by a number of medical schemes, managed care companies and administrators for:

  • Creating drug formularies for chronic conditions

  • Classifying all drugs and submitting correct ATC codes to the risk equalisation funds

  • Comparing prices of generic and therapeutic equivalents from different manufacturers

  • Building clinical patient profiles using our Nappi to ATC classification and ICD 10 crosslinks. This is done by confirming diagnosis based on drugs prescribed and is used when doing clinical data grouping

  • Determining a proxy diagnosis (actuarial firms)

  • Confirming diagnosis on medicine prescribed and building a clinical profile for each patient

  • Clinical data grouping as an ADG (Adjusted Clinical Grouper) or DRG (Diagnosis Related Grouper)

 

Nappi codes are cross-linked to all of the following:

  • Single Exit price and Cost price of all products

  • Product descriptions, dosages, pack sizes, schedules, presentations etc.

  • Active Ingredients

  • Generic Equivalents

  • Therapeutic Equivalents

  • ATC codes

  • Exclusion codes

  • Drug Interactions

  • Contra Indications

  • ICD 10 codes of the 25 CDL conditions

  • MMAP, MPL and MRP price lists

  • Medical Aid Formularies

  • EAN or Bar Codes

Occupational health clinic, IOD claims

Occupational Health Clinics, IOD (injury on duty) Claims Administrators, 

IOD Claim Solution Companies

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  • Pharmaceutical product and price file with all Nappi codes and SEP price of drugs

  • Consumables(0201) product and price file with all Nappi codes, product codes and cost price of all materials used.

  • ICD 10 Codes cross linked to PMB conditions

  • Use ATC classifications for drug utilisation studies.

  • Submit electronic claims via any EDI to the correct COID end destinations using correct transmission codes

  • Using drug classifications to confirm diagnosis based on medicine used and ensuring that medicine use falls within the required price range.

  • Capturing different treatment protocols used by different doctors and following scripting tendencies and the use of generic equivalents.

 

Medicine and surgical data is used for:

  • Claim submissions to medical aid

  • Building clinical profiles of the patient and the condition being claimed for.

  • Using drug classifications to confirm diagnosis based on medicine used and ensuring that medicine use falls within the required price range.

  • Capturing different treatment protocols used by different doctors and following scripting tendencies and the use of generic equivalents.

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Software, Electronic Data Interchange and Clinical Record Companies

 

Medprax forms an integral part of the standard database platform utilised by Practise Management systems, Clinical records systems, e-scripting software, Electronic data interchange(Switching) and Medical aids. Improving the flow of essential accurate, valid and correct data across all platforms.

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  • Comprehensive Drug database with all Nappi codes cross linked to

    • SEP

    • Product Description

    • MMAP, MPL and MRP reference price lists

    • Generic Equivalents

    • Therapeutic Equivalents

    • Active Ingredients

    • ATC codes

    • ICD 10 codes

    • Manufacturers

    • Generic, Original and Branded products flags

    • Essential Drug List products.

  • Comprehensive Consumables product and price data file

  • Radiology data files

  • Oncology data files

  • Medical aid data files

  • Essential link between tarrif codes and medical aids

  • Valid Medical aid Administrators, Schemes, Plans, Options cross linked to correct contact details and EDI codes.

  • Medical aid rules and remarks
     

Hospital Groups, Day Hospitals and Sub-Acute Facilities

​

​Hospital groups utilise Medprax data in Emergency units, Wards, Dispensaries and for drug utilisation studies and for the Antibiotic stewardship drive. Medprax data contains and can assist with the following:

  • Pharmaceutical and surgical Nappi price file requirements

  • Submitting claims to medical aid

  • Categorize medicine on the product master into generic baskets to facilitate procurement and dispensing.

  • Easily identify generic products available for dispensing

  • Use the product grouping code to analyse utilisation patterns to support the Antibiotic Stewardship drive as well as cost-management in hospitals

  • ATC classifications are used in nursing units to identify therapeutic subgroups and generic chemical substance

  • Identify Valid Administrators, Medical aids, Options and all contact details of Medical aid

  • Submit claims electronically to medical aid using EDI codes

​​

Measuring and monitoring the cost of drug treatments in hospitals and tendencies of doctors to use cheaper generic equivalents.

​

Evaluating the outcomes of using generic equivalents compared to originators and creating a list of cost effective preferred drugs to use for specific conditions.

​

Treatment outcome studies and infection control studies within hospitals.
 

Corporate Pharmacy Groups and Wholesale Chemists

 

Corporate pharmacy groups such as Shoprite/Medirite use the comprehensive Medprax data for business intelligence reporting and in combinations with demographics determine the drug groups most often used in a specific population area. This information is used for procurement of the correct medicine for each individual pharmacy.

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Medprax data is used to determine:

  • Manufacturer products sold more often in certain demographic areas

  • Price range of products sold more often in specific areas

  • Predominant drug classes and conditions dispensed for

  • Products reimbursed by medical aid more often

  • Products sold within MMAP, MPL and MRP

 

​​Pharmaceutical Companies

​

Pharmaceutical companies use pharmaceutical product and price data to:

  • Gain access to current, up to date price and Nappi code changes when they happen across the industry.

  • Compare pricing of drugs between different manufacturers and companies

  • Compare generic and therapeutic equivalents.

  • All Nappi codes cross linked to ATC codes and Therapeutic Equivalent

 

Managed Healthcare Provider Networks

​

  • Used for drug utilisation studies

  • Submitting claims to Medical aids

  • Used for Dispensing of drugs

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Drug Utilisation Studies

(Such as Netcare, Medi-Clinic, NHN Hospitals)

​

Hospital groups utilise Medprax data in Emergency units, Wards, Dispensaries and for drug utilisation studies and for the Antibiotic stewardship drive. Medprax data contains and can assist with the following:

​

  • Pharmaceutical and surgical Nappi price file requirements

  • Submitting claims to medical aid

  • Categorize medicine on the product master into generic baskets to facilitate procurement and dispensing.

  • Easily identify generic products available for dispensing

  • Use the product grouping code to analyse utilisation patterns to support the Antibiotic Stewardship drive as well as cost-management in hospitals

  • ATC classifications are used in nursing units to identify therapeutic subgroups and generic chemical substance

  • Identify Valid Administrators, Medical aids, Options and all contact details of Medical aid

  • Submit claims electronically to medical aid using EDI codes

 

Measuring and monitoring the cost of drug treatments in hospitals and tendencies of doctors to use cheaper generic equivalents.

 

Evaluating the outcomes of using generic equivalents compared to originators and creating a list of cost effective preferred drugs to use for specific conditions.

 

Treatment outcome studies and infection control studies within hospitals.
 

Robotic Prescription Dispensing Systems

​

Medprax forms an integral part of the standard database platform utilised by Practise Management systems, Clinical records systems, e-scripting software, Electronic data interchange(Switching) and Medical aids. Improving the flow of essential accurate, valid and correct data across all platforms.

​

  • Comprehensive Drug database with all Nappi codes cross linked to

    • SEP

    • Product Description

    • MMAP, MPL and MRP reference price lists

    • Generic Equivalents

    • Therapeutic Equivalents

    • Active Ingredients

    • ATC codes

    • ICD 10 codes

    • Manufacturers

    • Generic, Original and Branded products flags

    • EDL products ) Essential Drug List products.

  • Comprehensive Consumables product and price data file

  • Radiology data files

  • Oncology data files

  • Medical aid data files

  • Essential link between tarrif codes and medical aids

  • Valid Medical aid Administrators, Schemes, Plans, Options cross linked to correct contact details and EDI codes.

  • Medical aid rules and remarks

Software, electronic data
Hospital Groups
Corporate Pharmacy Groups
Pharmaceutical Companies
Managed Healthcare
Drug Utilisation
E-Script
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