Wemas introduces high-tech insurance medical care claim system 

In less than two years since its launch, Wella Medical Aid Society (Wemas) has introduced Biometric Smartcard system which is set to revolutionize insurance healthcare claim service.

Launched on Tuesday at Amaryllis Hotel in Blantyre, the biometric smart card system is touted to be a game changer on the medical insurance market as it simplifies the access to medical care for WEMAS members throughout the country.

It will also facilitate the quick submission of claims for their service providers — hospitals and pharmacies amongst others — leading to faster claims payments — making this to be the first to run a paperless claiming system in the country.

WEMAS members will be able to receive electronic claims on a real time basis thus making it possible to reduce the time taken to pay claims.

The high-tech system has been created in partnership with Kenyan  company, Smart Applications International Ltd, a leading biometric ICT service provider that is now operating in 10 countries across Africa — Kenya, Uganda, Rwanda, Zambia, Tanzania, South Sudan, Somalia, Somaliland, DRC and now Malawi.

It services over 5,000 healthcare facilities with over 1 million members in these countries.

Smart has now entered the Malawi market through the provision of its Smart Automated Medical Scheme Management Solution (MediSmart) using biometrically controlled smart card technology.

At the official launch, Wemas Chief Executive Officer, MacDonald Wella said this marks another milestone in their journey that they promised would continue to be as innovative as possible to serve their clients better.

“The launch of the Biometric smart card system is a clear sign that Wemas lives true to  its mission of being the most innovative medical scheme in Malawi,” he said.

“In addition, one of the key benefit to members the solution provides is the transparency that this system will bring, members will be able to monitor their benefit balances each time they go to the hospital.

“Our market is full of secrecy as far as member benefits are concerned and this secrecy results into mistrust from members of medical schemes which in turn breeds fraudulent claims.”

“We have sang the song of combating fraud on our market for too long but without any action. Now WEMAS is leading so that all the other medical schemes can follow.

“The battle against fraudulent claims is almost won here,” he said of the system in which the members’ benefits are well secured as it needs a fingerprint identification process.

When medical insured patients access services in hospital or pharmacies, they are required to fill in claim forms which the service providers channel to the medical scheme society for their financial claims.

Wella assured its members that the new technology will help WEMAS members’ easy access to health services, automation of manual processes and elimination of paperwork leading to higher efficiency and faster payment to healthcare facilities.

“We are happy with the expansion of the MediSmart solution into Malawi and are looking forward to partnering with both medical scheme administrators and healthcare facilities across Malawi for better healthcare outcomes,” he said.

Present was Smart Applications International’s group managing director Harrison Muiru, who assured Malawians that the entry into Malawi is inline with Smart’s vision on creating a world of convenience while enabling secure, fast access to healthcare service across Africa and beyond.

He said Smart should now not be considered as a Kenyan company but an African entity that has been incorporated in the Malawian industry to revitalize the medical care application through technology.

He added that for the past 15 years, Smart has been looking at transforming management of healthcare system across Africa and he congratulated Wemas for taking the bold step to being Malawi’s first medical service provider to take such a bold step.

Also present at the launch was the group’s marketing director, Esther Kiringa, country director for Malawi as well as several of Smart’s members of staff from Kenya.

Wemas, owned 100% by Wella Holdings Limited, was launched in April last year and amongst its innovations— also the first of its kind — is its scheme that guarantees cash back on underutilized monthly contributions at the end of the year.

The cash-back is under the scheme, Medical Savings Plan (MSP), works the same way as a bank savings account and as a cash account strictly for payment of hospital bills as outpatients.

The member uses this money for their medical expenses and if a member claims less than 50% of the cash allocated to their MSP, they are allowed to withdraw the remainder on the 50% at the end of the year.

This is an unique innovation of rewarding its members for staying fit if they don’t get ill and didn’t make any claims for medical cover.

Other products and services are Pensioners Medical Scheme; Gap Cover; Corporate Medical Scheme as well as Family Medical Scheme and all these have funeral expenses cover of K500,000 up to K1 million.

The Pensioners Medical Scheme provides medical benefits for people who are above 55 years old and it also includes a generous free funeral cover benefit.

At the launch last year, Wella said pensioners on their scheme “have access to the best hospitals in Malawi to ensure a better life during their Golden Years” while the Gap Cover is “designed for those people who are members of other medical schemes which make them pay shortfalls at the point of service”.

This product pays for the shortfall while their medical scheme pays for the main hospital bill to ensure that 100% of the medical bill will be covered and the member pays nothing at the point of service.

The Family Scheme range of products are designed to give cover to the family as a unit. They pay one premium and they have a common benefit pool from which each member taps for their medical treatment all the year round.

The Corporate Scheme is also group of products designed for corporate employees. These two group schemes have three covers, Mtende, Moyo and ThanziPlus.

Mtenje is the highest cover within the Corporate/Family range in which  members pay monthly premiums and they are given outstanding medical benefits and that 50% of their monthly premiums is allocated to their Medical Savings Plan from which their out-patient benefits will be paid and this money can be used for medication as they wish.

Moyo is the middle cover in which members are given medium range benefits and also 50% of their monthly premiums is allocated to their Medical Savings Plan from which their out-patient benefits will be paid.

ThanziPlus is the economy cover and also 50% of monthly premiums is allocated to Medical Savings Plan for their out-patient benefits.

Members are able to access WEMAS services in over 70 health service providers across the country that include Mwaiwathu Hospital, Blantyre Adventist, Masm Medi Clinics, Adventist Health Centre (Lilongwe), Lilongwe Private Clinic, City Centre Clinic, Shifa Hospital, Malmed (Blantyre, Ginnery Corner, Zomba), ABC Community Hospital as well as Likuni Mission Hospital.

In the case that a patient has been referred to a specialist hospital out Malawi, WEMAS shall only pay the medical bills there while the patients shall meet transportation and accommodation expenses there.

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