Technology ahead of its time
Performance Health has uninterrupted access to trusted and dynamic IT systems, robust processes, and experienced staff that enable caring for the health of medical scheme members through proactive, evidence-based medicine principles and electronic claims adjudication rules applied in real-time.
Technology ahead of its time
Performance Health has uninterrupted access to trusted and dynamic IT systems, robust processes, and experienced staff that enable caring for the health of medical scheme members through proactive, evidence-based medicine principles and electronic claims adjudication rules applied in real-time.
As a business we are configured for optimal performance, redundancy and security with a robust cyber security framework ensuring the safety, confidentiality, integrity and availability of data. In addition, the instantaneous nature of the Performance Health platform provides healthcare providers and medical scheme members with information at the point of service, thereby affording the benefit of choice and ensuring accountability when it comes to healthcare decision making.
The Performance Health ICT platform provides healthcare funders with considerable value, including:
- Claims processing for medicine, pathology and radiology services are provided online in real-time.
- Systems that are always on and available, guarantee an uptime of 99.5% with a response time of 30 seconds or less.
- Processes, systems and methods of processing that are ISO 9001:2015 certified.
- A patented rules engine that ensures accuracy and speed of online real time claims processing
- The rules engine utilised has been awarded an international patent (US Patent 8,185,414), demonstrating the globally unique nature of the technology employed.
- A robust cyber security framework to assure the safety, confidentiality, integrity and availability of data.
- A paralleled flexibility in IVR programming.
- Computing and ICT platforms that process big data are up to date, generously specified and all have comfortable levels of spare capacity.
In instances where the client, healthcare funders or administrator are not available to provide a real-time response we are able to adjudicate claims in stand-in so that healthcare providers, members and their beneficiaries, will at all times experience uninterrupted service.