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RTCPS to eliminate health claims payment bottlenecks

Local News
FROM LEFT: Salutem managing Ruka Nyoka, Tres Groupe International chief operating officer Mufudzi Mupunganyi and director for pharmacy services in the Health ministry, Newman Madzikwa, test the innovative solution at the launch

NEWLY-LAUNCHED Real Time Claims Processing and Payment (RTCPS), a digital technology platform, is set to eliminate health claims payment delays and enhance trust among stakeholders, Health minister Douglas Mombeshora has said.

Pioneered by Salutem International Medical Fund, a member of the Association of Healthcare Funders of Zimbabwe (AHFoZ), the new model is expected to reduce the cost and increase access to private healthcare.

It seeks to increase transparency and convenience while eliminating shortfalls.

“I am pleased to witness technological advancement in the medical aid sector in the form of RTCPS. This should fundamentally deal with the recurrent challenges of a late settlement of claims, which have culminated in the breakdown of trust among service providers, patients, and medical aid societies,” Mombeshora said in a speech read on his behalf by director of pharmacy services in the Health ministry, Newman Madzikwa.

“Instant settlement of claims shall capacitate medical providers to offer sustainable services to the people of Zimbabwe. It is progressive, therefore, to see the introduction of a secure transactional medical aid card. This will provide comfort to the members and restore trust and medical aid relevance.”

The Health minister said the instant payment to medical providers “should eliminate forward pricing, thereby reducing the extent of shortfalls, which ultimately reduces the high out-of-pocket expenditure at the point of care”.

“The model should assist cashflow challenges even at the public hospitals when they start receiving claims payments on the go. This should reduce pressure in the fiscus as any effects of currency depreciation are eliminated at the point of care,” he said.

Witnessing the momentous occasion, ICT and Courier Services minister Tatenda Mavetera pledged support for the continued convergence between ICT and healthcare to revolutionise access to medical services.

“We will continue to support the health sector by promoting ICT literacy and utilisation, as well as develop supportive and enabling infrastructure to ensure equitable access to healthcare including disadvantaged groups and rural communities,” she said.

“I am certain we will see the innovative technology witnessed today (Friday) merge with the rise of telemedicine. This would enable us to create a healthcare future that is patient-centred, efficient, and equitable. Let us embrace these advancements and work towards a healthier tomorrow.”

Ruka Nyoka, Salutem managing, said they had listened to calls by healthcare stakeholders, including patients and medical practitioners.

“Our solution to the Mexican standoff between service providers, funders and the member is our novel RTCPS. This allows automation of claims processing from 60 days to 60 seconds,” Nyoka said.

“Medical practitioners here present, we have listened to your call. This innovation frees AHFoZ and allows them to focus on innovations and big ideas to make the healthcare funding sector better.

“As we introduce digital medical records, the system will eliminate fragmented medical records, while retaining confidentiality.”

Salutem is registered with the Health and Child Care ministry and is administered by Tres Group International.

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