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Member Relations Management

Our Member Relations Management (MRM) division is made up of a team of qualified medical professionals, who together advise the scheme and its members on disease management, the treatment of chronic conditions, how to lower costs, and more.

What does the MRM division do?

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.

How do members benefit?

Financial and emotional peace of mind is top of the priority list for MRM. No need to worry about costs: our pre-authorisation and pre-quote system guarantees payment of approved claims, and means no unnecessary or inappropriate treatment.

When you phone MRM, you are immediately assisted by a member of our team – not a telephone operator. Thanks to the team’s specialised medical knowledge and industry experience, you can get meaningful advice when you need it most.

The existence of the MRM division means that members have access to personalised case management at all times, as well as emotional support and counselling for themselves and their families in the event of hospitalisation.

Perhaps most importantly, the MRM division ensures that the combined contributions of members are spent as wisely as possible – this way, everyone benefits.

Find out more about MRM

For more information, or to obtain pre-authorisation for hospitalisation, medical procedures and chronic medication, please contact our MRM division via: 


•  Telephone: 021 937 8300;
•  Fax: 021 930 6838, or
•  Email mrm@cmp.co.za.

 


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