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OTI PetroSmart

Smart
SMART Applications International

OTI PetroSmart has partnered with Smart Applications International Ltd. (SMART), a Kenyan company committed to delivering technology-driven secure healthcare solutions, to implement MediSmart across East Africa. MediSmart has been deployed nationally in Kenya and points of service have been established in Uganda, Tanzania, Rwanda, Sudan and Zambia. With over 3,500 MediSmart enabled billing points, this solution is accepted as the de-facto process for accessing healthcare in East Africa. The solution caters for cross border access with currency conversions supported across multiple countries.

The MediSmart Solution

Up to 75% of patients in Kenya receive their primary healthcare services at public hospitals. With OTI’s MediSmart, SMART is able to provide a complete healthcare informatics solution including cards, readers and related software that are seamlessly integrated with hospital management systems. The OTI MediSmart solution offers secure and fast front-end patient authentication and benefit verification at the service provider level. It securely stores emergency medical information allows for electronic clinical data capture and retrieval of medical records and electronic claim and/or report generation, taking into consideration benefit rules in respect to services provided and benefit utilisation. At the same time the information is recorded on each patient’s personal MediSmart card (or mobile data repository), relevant data is transferred to the corporate and insurer levels. With MediSmart, statements and invoices are generated faster, administration time and cost are reduced and, since claims are authenticated electronically, it further guarantees payment and reduces payment cycles at the provider levels.

MediSmart-Our Promise

Results – Huge Reduction In Fraud

One of the main goals of MediSmart by storing electronic health record on portable devices is to  reduce fraud. Kenya’s Business Daily estimates that fraud in the medical insurance sector causes revenue losses of 40 percent of total claims. It causes higher insurance rates at a time when providers are scrambling for more business. The MediSmart solution effectively addresses attempts to fraudulently access medical services. It is now widely acknowledged that MediSmart cards are yielding cheaper premiums for group medical schemes. Insurers who are implementing MediSmart control about 70% of the market. Outside the corporate world, less than a million Kenyans out of an estimated workforce of 12 million have private medical insurance cover. Curbing fraud will improve cash flow and result in a review of premiums enabling the industry to expand its possible market. By enabling cardholders to verify their benefit entitlement at the point of service, MediSmart enables members to manage their healthcare expenditure more effectively.

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