MRM is responsible for a number of member-related processes, all aimed at ensuring the best possible care and service at reasonable rates for our members.
If you are diagnosed with a chronic or serious condition, the MRM team will independently assess and discuss your planned treatment with your doctor to ensure that it is medically correct for your condition, age profile and medical history.
If hospitalisation is required, MRM will oversee the necessary pre-authorisation and personally manage your treatment and level of care throughout your stay. If necessary, they will continuously liaise between your doctor, the hospital and your family.
The MRM division will also handle pre-authorisation requests for medical procedures, and review your doctor’s quote to ensure that you are not being overcharged. Upon request, they can provide the contact details of doctors who charge competitive rates.
The Chronic Disease Management programme is one of two specialised programmes operated by the MRM division. Any member diagnosed with a chronic condition must register for the programme. In order to continue to receive the chronic medication benefit members must submit 6 months prescriptions to the scheme. The MRM team reviews and approves all chronic medication benefit requests according to CMP’s formularies and protocols, and helps members monitor their condition and treatment. The team is also responsible for selecting Preferred Providers, and negotiating the best possible tariffs with them, resulting in better pricing for quality care.
The second specialised programme that falls under the care of the MRM division is Mum’s the Word, CMP’s maternity programme for expectant mothers.
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