One Account per Patient

Made to Measure software works with one account per patient. This is different to most other medical suites where the main Medical Aid member holds the account and all dependents are loaded under that one account.

Advantages/ Disadvantages of the 1 acct per ‘family' system.

In the past this type of system did make sense in that medical aid membership was a family affair with the father being the main member and his wife and children dependents on his medical aid. Often the medical aid fund would be linked to his employment and nothing ever changed – He stayed on the same medical aid at the same place of employment for 20 years and his wife and children remained his dependents until the children became self supporting.

With this system the medical aid /address /telephone info applies to the main member and is loaded only once. The dependents underneath the account each have their patient info inclucing name /diagnosis/dob and id etc.

New legislation, designed to combat medical aid fraud, now allows medical aids to demand a lot of info per patient eg ICD10 code, patient id etc. This means that on every line that is printed on the account, all the patient info must be included - so that in addition to date, procedure, value, and diagnosis, the patient name, dob and id must be listed. As a result the software needs two lines to print each treatment, or it needs to use a font that is so small that the statemnt becomes difficult (especially for old people) to read.

Advantages/ Disadvantages of our 1 acct per patient system.

These days families, employment, and medical aid membership are much less stable and are subject to constant change. Individual family members may belong to different funds because of the different benefits offered. Complicated extended family structures can result in children changing from their father's to their stepfather's fund; spouses to a new partner's fund or to a new employer where a superior option is available; parents becoming dependents on their children's funds. As the different funds increasingly target specialised markets, clients have a big variety of choices.

Holding a separate account (under a medaid main member name) for each patient ensures that the medical aid, adr, telephone, cell etc info loaded is for this patient, and not for a ‘main member' who may be her husband, father, ex-husband, daughter, live-in partner etc. Should the main member change at any time, the account number, patient data and patient account history will all remain on the original account.

When printing a treatment line the minimum amount of info can be printed because the patient info of id number, name, dependent code etc is already printed at the top of the account. Therefore we have so far been able to keep treatment line to one line of printing in an easily readable font, substantially reducing printing costs.

This system is really only a disadvantage for GP's who regularly see whole families. Physio's, OT's, specialists etc should not see this as a problem. To make data capture easier we have developed a copy-add function that sets up a new acct with all medaid and main member name and adr copied from an existing account. If statements are printed in surname order then it should be easy to put any going to the same person into a single envelope.