The Importance of Good Medical Scheme Service

January 8 - While the most important thing that most people look for in a medical scheme is longevity and a sterling reputation, another factor that should not be overlooked is customer service.

Many consumers may not be aware that there exists a minimum standard that medical schemes are obliged to offer their customers, known as the Service Level Agreements.

Service providers have created the SLA in a bid to provide customers with acceptable levels of support, and these include issues such as call answering, claims processing and new membership.

The SLA states that 85% of all calls should be answered within 30 seconds, while 90% of claims should be processed within 10 working days.

New members should be fully registered within 4 working days and complaints need to be resolved within five working days.

"The Medical Schemes Act stipulates minimum levels of service that members can expect to receive," said the Chairman of Medshield Medical Scheme, Thabo Mabeta. "These provide a critical benchmark for schemes wanting to offer the kind of service that will win them favour with their members and hopefully prevent them from moving to competitors."

Mabeta concluded: "As schemes try their best to tailor benefit options according to their members' needs, it's inevitable that many schemes might be offering packages that aren't actually that dissimilar. So what will make a consumer choose one scheme over another? Possibly longevity and the peace of mind that a scheme isn't a fly by night operation? But just as importantly, the knowledge that a scheme offers excellent customer service at a time when you probably need it most."