This is the most important area of services to be provided by any healthcare management and administration or managed care organisation. Our medical team will ensure that medical management shall be an integral part of the services that we provide to its corporate clients. With a proven track record in managing 650,000 members as at today, we are able to provide the medical management in terms of quality assurance and benchmarking and preventive programs in either one or a combination of the following:-

• System driven - where a set of parameters are incorporated based on our experience having managed and administered since the last 18 years to process the medical claims that are submitted from the medical providers. Claims that breach the established parameters will be scrutinized in detail by our medical team;

• Retrospective case management - where the charges of medical treatment is checked and verified on the reasonableness of the charges based on the treatment provided by a particular medical provider. We will ensure that the charges are justifiable with the treatment provided by the medical provider based on the patients condition and the level of sophistication of the said treatment. Whenever we need to negotiate with the relevant medical provider, we will do so with the objective of having the medical charges reduced while maintaining the quality of medical delivery;

• Proactive case management - although minimal intervention is exercised, we will advise the patient of all available options to the patient based on the patients benefit entitlement. The decision to choose whichever avenue of treatment will be at the sole discretion of the patient provided they are within the patients benefit entitlement. Further, once we have collated the relevant data for a certain period such as one year, we will design a relevant treatment program in the following year for relevant patients of selected diagnosis to follow in order to mitigate the condition of the patient not to deteriorate further. This includes a schedule of visits to the relevant medical specialty by the identified patients; and

• Preventive program - whilst part of the program has been elaborated in the proactive case management, this program focus on providing the patient with useful information of their related illness and what are the dos and don'ts for them not to aggravate their conditions, or most importantly to prevent them from having at all. Immunisation for children is managed and administered systematically by us. The types of immunisation will be of those recommended by the Ministry of Health, Malaysia.