Being in good health is of prime importance. Indeed, it is one of the most beautiful gifts in life. Thus, first century Latin writer Publilius Syrus once said “good health and good sense are two of life’s greatest blessings”. Private medical insurance has played a major role in enhancing access to quality healthcare over the years. Presently, there are more than ten (10) private medical insurance providers in Ghana serving a total population of over two hundred thousand (200,000) members. Making a grand entry into the industry is ACE Medical Insurance Limited (Ace Medical).
Medical Insurance Limited was incorporated as a limited liability company with the primary aim to contribute, to a large degree, towards the socio-economic development of Ghana. Ace Medical Insurance Limited has been licensed by the National Health Insurance Authority, under the National Health Insurance Act 2012 (Act 852), to function as a private commercial health insurance scheme. Managed by a team of accomplished professionals with experience and expertise in a broad spectrum of activities, the company provides exceptional services to clients, job satisfaction to staff, and increased returns to shareholders and stakeholders. Ace Medical seeks to become the dominant player in the healthcare financing market.
Products offered by Ace Medical
Services offered by Ace Medical can broadly be grouped into four (4) categories namely:
- Corporate Medical Insurance Plans – Data driven and meticulously designed health insurance plans to provide staff as well as registered dependents of corporate entities access to healthcare of the highest standard.
- Individual Medical Insurance Plans – Affordable health plans to meet the healthcare needs of individuals and families. These plans provide cover for consultations, diagnostic tests and procedures, and medications.
- International Health Insurance Plans – These cover referrals to and general healthcare at medical centres outside Ghana.
- Third Party Administration (TPA) Services – Founded on concept of self-insurance, Third Party Administration involves an organization outsourcing the administration/operationalization of their system for providing healthcare benefits, to an Administrator, Ace Medical. In this role, Ace Medical will assist the employer to design and implement the benefit plan for the self-insurance system. Ace Medical will also undertake service provider management, claims management, reporting to ensure transparency, and some customer support services.
What Makes Ace Medical Different
- Ace Medical is the only private health insurance scheme that specialises in offering both bespoke health plans (plans specifically designed according to client’s needs and budget) and generic health insurance plans.
- Ace Medical has highly qualified, experienced, well-resourced, and motivated workforce. These are consistently trained on the latest practices and trends in the healthcare financing industry.
- Ace Medical has developed an enviable Corporate Culture that promotes innovation, creativity, professionalism, and discipline.
- Ace Medical has invested in and is continually in search of the latest information technology systems to improve service delivery to clients.
- Ace Medical has a solid financial foundation.
Information Technology Drive
Information technology is vital in the health insurance industry to enhance efficiency in claims management and consequently increase the speed of claims payment. Information technology tools can also be employed to enhance transparency and improve customer experience. Ace Medical is committed to adopting the latest tools to ensure that clients are freed from the numerous challenges that have plagued the industry in the past.
Ace Medical App
The Ace Medical App is a unique mobile application (both Android and iOS) for members of Ace Medical Insurance Limited. Whereas the mobile applications in use by competitors in the industry is a generic form with the same features, the Ace Medical App has been customised for Ace Medical Insurance Limited only. The Ace Medical App thus builds on the generic features of assisting members locate and rate service providers, and checking their healthcare usage data, by enabling members to easily book appointments with service providers. Members can also verify the availability of prescribed medications at pharmacies before moving to the location. Ace Medical firmly believes that it is rather ironic for the search for a cure to aggravate the ailment being cured. The company’s aim is thus to make accessing healthcare a stress-free experience for its members to aid in their quick recovery.
In addition to the mobile version of the App, members can also access a web-based version with any web browser.
Electronic Self Enrolment
New members can easily fill out registration forms on Ace Medical’s highly interactive website. Once this is submitted, it is delivered to an in-house member management system for approval and membership card issuance. This has significantly reduced the time and effort involved in processing new enrolments, for both members and Ace Medical.
Additionally, new members of corporate clients can register via a link sent to them by their Human Resource representatives.
Human Resource Portal
The healthcare financing industry relies heavily on accurate healthcare usage data. Such data, among others, serves as a basis for determining premiums payable by clients. It also forms the basis of some human resource decisions and plans by clients. Especially for clients with bespoke health plans; there is the need for them to be assured of the judicious use of their budgeted healthcare funds – possible only with accurate and reliable healthcare usage data. Transparency is key if such healthcare usage data is to be relied upon by clients. To achieve this, Ace Medical’s online Human Resource Portal can enable designated human resource personnel of clients to view summary reports (WITH NO IDENTITIES DISCLOSED) on the healthcare usage of their group. The reports reflect the cost of healthcare, and ailment trends for the group. With the HR portal, designated human resource personnel can as well comfortably (in their offices) add or remove members from their plan, in addition to several other functions in managing the healthcare of their members.
Electronic Claims Management System
Claims management forms an integral part of the operations of an insurer. If done efficiently, it can contribute significantly to an insurer’s sustainability and profitability, as well as considerably reduce potential conflicts with service providers.
Recognising this, Ace Medical has adopted an electronic claims management system in its quest to mitigate the challenges of the paper-based system. The electronic claims management system enables service providers to verify the membership of patients using the member’s photograph displayed in the system. Service providers are also enabled to submit claims in real time, meaning quicker claims processing and subsequent payment by Ace Medical. Members’ benefits information that previously could not be accessed by service providers at the time of offering care is now available to them through the electronic system. The system as well offers service providers a first level vetting feedback prior to claims submission. These features help to ensure that members are offered the services necessary and appropriate for their diagnosed conditions. The electronic claims management system has greatly improved archiving and retrieval of archived claims data for both Ace Medical and the service providers.
This is an individual’s membership card displayed on their smartphones. The E-card comes in handy when members need to access healthcare but do not have their membership cards on them. Displaying all the features of the printed membership card, the E-card can be shown to an accredited service provider on the member’s smartphone for services to be rendered. This ensures that members are not denied much needed healthcare by reason merely of the fact that they do not possess their printed membership cards.
The relevance of healthcare to the growth of every business and the nation cannot be overstated. Every individual in the country needs to stay healthy to have the sound mind to work for the growth and development of their business and the country at large.
Founded on the radically simple idea that everyone deserves the chance to live a healthy life, ACE MEDICAL is very well positioned above its competitors to help achieve this goal of making affordable, accessible and quality healthcare services available to all individuals and corporate institutions.