One member record everyone can rely on.
Members, their dependants, who is suspended, what each plan allows and how much of it is left — all on one record, and it is the same record the claims desk reads. So a question about cover is answered there and then, not sorted out weeks later.
Free test run. Wizards and training so you can set it up yourself. Nothing to commit to.
One member record — the group, the contacts, and every member with their plan, dependants and premium.
The current way
You are paying for cover that already ended
Members join, leave, add a child and get suspended every week. If the claims desk is looking at last week's list, you pay for the difference — and your staff retype the same changes in three places.
Current way
Membership is maintained in one system and claims assessed in another.
Consequence
Suspensions, cancellations and dependant changes reach the claims desk late.
Bigger problem
Claims are paid outside cover, and recovery afterwards is expensive and rarely complete.
Current way
Cover rules live in scheme documents and in people's memory.
Consequence
Two members of staff read the same limit two different ways, and small arguments become big ones.
Bigger problem
What your product actually pays for is decided by whoever happened to pick up the claim.
Current way
Hospitals phone your office to ask whether someone is covered.
Consequence
Your desk spends the day answering the same question, and after hours the hospital simply guesses.
Bigger problem
People are treated who should not have been, and you only find out when the claim arrives.
Current way
Nobody at the desk knows a referral was required.
Consequence
The member is seen anyway, and the referral letter is chased afterwards, if ever.
Bigger problem
You pay for visits your own rules said needed authorisation first.
How it works with M‑Care Suite instead
One member record that everyone reads
Cover stops being a list you check later and becomes the answer every other part of the system uses.
Set up
You put your plans and rules in once, with a wizard
The wizard takes you through each plan — what is covered, the limits, the smaller limits inside them, co‑payments, waiting periods and what is excluded — and keeps a dated copy of every change you make.
Limits and sub‑limits
Waiting periods
Every change dated
Result
Your product is written down once, in the system that applies it.
Stop doing
No more checking one list against another
Main members, dependants, suspensions and cancellations are kept in one place and read straight away by the claims desk and by finance.
Dependants included
Suspensions seen at once
One list only
Result
Arguments between departments about who is covered end.
Automatic
Joiners, leavers, renewals and cards
Additions, removals and renewals follow your own steps and start dates, and cards and confirmations go out on their own.
Start dates honoured
Renew in bulk
Cards issued
Result
Renewal season stops creating a backlog.
The hospital checks
They confirm cover themselves, before they treat
Every hospital and clinic has its own window in M‑Care Suite. They look the member up and see whether the person is covered today and whether the service in front of them is inside that member's cover — a yes or a no, with no balances shown, so nobody is tempted to treat up to a limit.
Covered today, yes or no
Is this service covered
No balances shown
Result
Your desk stops answering the same question all day — and shows nobody what is left to spend.
The system warns
It says when a referral letter is needed
If that member can only be served at that kind of provider on referral, the window says so before anything is done — so the member is asked for their referral or authorisation letter at the desk, not after the bill arrives.
Referral required — shown
Authorisation needed — shown
Asked for at the desk
Result
You stop paying for visits that should never have happened without a referral.
You get
A clear view of how much cover you are carrying
How many lives you cover, how much of each limit has been used, and how much is left — per scheme and per company.
Lives covered
Limits used
Per scheme and company
Result
You see the risk before you price the renewal, not after.
Worried about moving your members?
You shouldn't move a member list on trust. Here's how M‑Care Suite lets you check every record before anything goes live.
You might be thinking
“Our member records are messy.”
What we do
The system shows you what needs fixing.
Load a copy into the free test run and it lists the duplicates, the missing dependants and the dates that do not agree, so you can tidy them before you go live. Ask us and we will go through the list with you.
A written list of what needs fixing, before anything goes live.
You might be thinking
“Our rules are unusual.”
What we do
You put your real rules in and test them.
Your actual limits, the smaller limits inside them and what you do not cover all go in through the wizard. Then run past claims and see whether the system reaches the same answers you did.
Free test run with your own rules and your own past claims.
You might be thinking
“We cannot disturb members in the middle of the year.”
What we do
You move across one scheme at a time.
One scheme moves, your old way keeps running beside it until you are happy, then the next one follows. Members notice nothing.
One scheme at a time, both ways running together.
Make “is this person covered?” a question with one answer
Try it free on one of your schemes and see your own members, plans and rules working off one record.
Free test run. Wizards and training so you can set it up yourself. Nothing to commit to.
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