Welcome to PMCare
We help to manage and administer various combinations and permutations of our corporate clients' medical benefit programmes. With a proven track record of managing close to 650,000 members as at today, we are committed to provide quality services to our members. We have a strong network of 2,000 affiliated medical providers located throughout Malaysia. PMCare processed close to 3.8 million medical claims worth of RM1.02 billion in year 2013.
We manage because we care. That's PMCare4U.
rivatisation has been actively pursued by the Malaysian government since the 1980’s where a number of the government bodies or agencies were transferred to the private sectors to be managed and administered by them as profit centres instead of cost centres. The idea of privatisation or outsourcing is not something new, especially to the developed nations. The practice of outsourcing is common amongst the private sectors and this enabled them to focus on their core business, which will generate income for the organisation.
anagement and administration of various healthcare programmes are PMCare’s forte. The services that PMCare have established stem around the basic idea of the need to outsource the management and administration of the delivery of medical benefit programme extended to the employees by their employers. On the same note, insurance companies would also benefit by outsourcing the management and administration of the medical policies that they have issued in favour of their policyholders, be it individual policyholders or corporate policyholders.
entral management tracking system is essential to PMCare’s efficient data management. Our Medicare Integrated Information Exchange or MiX is the backbone to PMCare’s operations. The MiX is now in the 10th generation since we first designed and developed it in 1996. The healthcare programmes managed and administered by PMCare are no longer fragmented but instead integrated from the primary care right through to tertiary care.
s the same medical providers who are providing medical services are engaged by PMCare, quality of healthcare would not be affected and should be of the same quality, if not better.
esearch and analysis are also carried out by PMCare’s Utilisation Review Committee with the objective of advising our corporate clients and the insurers of their healthcare programmes as compared to the market practice.
volution is something that none of us can avoid from. Healthcare delivery, which used to be fragmented, has now evolved into an integrated delivery system which is efficiently managed and administered by PMCare through MiX.
PMCare Sdn Bhd ("PMCare”) is a BPO provider specialising in management and administration of the corporate clients’ medical benefits extended to their employees and eligible dependents. PMCare was incorporated on 28 February 1998 under the original name of HMO Pacific (1998) Sdn Bhd as a private limited company under the Companies Act, 1965 to take over the business of HMO Pacific Sdn Bhd ("HMOP”). HMOP was the pioneer to bring the concept of managed care into Malaysia in 1995. Pursuant to a corporate restructuring exercise, we changed our name to Pantai Medicare Sdn Bhd which was subsequently renamed as PMCare on 16 January 2004. The Company’s authorized and paid-up share capital as at today stands at RM5.0 million and RM1.0 million respectively.
In 1996, we designed and developed our own application software based on our own specifications. It took us about one and half years to write and test the software application. Between July 1997 and January 2003, several upgrades and improvements were done and the system, previously called Central Management System was subsequently renamed as "MiX” in shortfor Medicare Integrated Information Exchange.
Because of the flexibility and robustness of our MiX, we are able to manage and administer various combinations and permutations of benefit entitlements or healthcare programmes. The healthcare programmes can either be self-insured, where the actual medical expenses are being borne by the clients themselves or on the other hand, if the clients wish, can be fully insured by appointed licensed insurer. Alternatively, the insurers themselves can appoint us as their Third Party Claims Administrator to manage and administer their medical policies portfolio.
In order for us to process the medical claims from the medical providers, we need to capture the data. Capturing of data can be done in two ways such as manual data entry and on-line through the Internet. Mediline™ is a web based application system to facilitate or assist the panel medical providers to verify and validate members, on-line claims submission and generate claims summary report which can be used as a statement of accounts.
Medifile™ is a business intelligence system that collates and manages information given to the company, and produces reports for analysis by the relevant member organization. Its web-based feature allows it to be accessed from anywhere in the world, 24 hours a day. The reports are confined to the data of therespective corporate clients only and are provided for now into 2 tiers:-
Tier 1 is the KPI type of reports which are useful to the heads of organization with colour coded to signify the status of the data. For example, green is for normal, yellow is for alert, and red is for urgent actions need to be taken.
Tier 2 is the detailed reports which are useful to the middle management. These reports can be further drilled down to the smallest denominator which is the employee such as amount incurred, number of visits, name of medical providers visited, etc.
It serves like a personal ledger of the member. Other reports can also be generated such as on the medical utilisation by months, the trend of diseases, total amount of treatment costs, average cost per treatment, type of medication used and average cost for medication, etc.
PMCare's strength is in our personnel and our efficient systems namely MiX,Mediline™ and Medifile™ which provide the Company with the right tool for collating data, managing information and producing report in order to make informed decision. About 80% of our staff are in the Medical Department, Claims Department and Operations Department, which we believe are the most important divisions of any managed care organizations ("MCO”).
We are confident that with our proven track record and experience, and being the first and only MCO in Malaysia to be certified ISO 9001:2000 by Certification International (UK) Ltd, United Kingdom, we can position ourselves to be the leader in the management and administration of the delivery of healthcare in Malaysia.
We have more than 250 employees. About 80% of our staff are from the Medical Department, Claims Department and Operations Department, which we believe are the most important divisions of any MCO.
Dato' Wan Shukri Ariffin - MBA, B. Sc, DBS
Dato' Wan Shukri Ariffin is a holder of a Masters Degree in Business Administration specializing in International Management from the Golden Gate University, San Francisco and Bachelor of Science Degree in Marketing from Syracuse University New York in the United States of America.
He has vast experience in corporate services having served Bumiputra Merchant Bankers Berhad for 8 years. Wan Shukri was instrumental in the setting up of HMO Pacific Sdn Bhd ("HMOP”) in 1995 and bringing in the concept of MCO into Malaysia. He became the Chief Executive Officer of the Company in April 1996. Dato' Wan Shukri and Adzahar Abdul Wahid did a management-buy-out from the previous shareholders of HMO Pacific Sdn Bhd ("HMOP") during the economic and currency crisis in 1997, and subsequently transferred its business operations to PMCare in 1999 pursuant to corporate restructuring exercise.
Together with Adzahar, Dato' Wan Shukri designed and developed the Medicare Integrated Information Exchange or MiX, an internal application software to be used as the backbone for the entire business of PMCare. Dato' Wan Shukri and Adzahar have formulated the policies and strategies, and steered the direction of the Company towards becoming the premier BPO provider specialising in healthcare management and administration services in Malaysia.
Dato' Wan Shukri also sits on the board of Tasek Corporation Berhad as Independent Director and Board Audit Risk Committee since 2004. He is also the Chairman of Powercomp Group and Director of several other companies.
Adzahar Abdul Wahid - CA (M), CFP, FCCA
Chief Executive Officer
Adzahar Abdul Wahid is a chartered certified accountant by profession. He is a Fellow of the Association of Chartered Certified Accountants United Kingdom, a Chartered Accountant of Malaysian Institute of Accountants and a Certified Financial Planner being a member of the Financial Planning Association of Malaysia. He has vast experience in the areas of accounting, auditing, finance and corporate services. He did his accounting and auditing training in the United Kingdom before serving Bumiputra Merchant Bankers Berhad for 6 years. He subsequently served Naluri Berhad as Corporate Finance Manager.
Adzahar joined the Company in 1995 as a General Manager of Finance and was appointed as the Executive Director in April 1996. He is instrumental in the development of PMCare's internal applications software or the Central Management System which was subsequently upgraded and improved and renamed as MiX.
Adzahar was the Independent Director and Audit Committee Chairman of Kencana Petroleum Berhad for 6 years from 2006 to 2012. He later was appointed the board of directors of the merged entity SapuraKencana Petroleum Berhad before resigning in September 2012 to focus on the expended activities of PMCare.
Kamal Aryf Baharuddin - BA, CA (M), ACMA
Chief Operating Officer
Kamal Aryf Baharuddin is the Chief Operating Officer and has been with PMCaresince 2000. He is an Associate Member of Chartered Institute of Management Accountants, United Kingdom and a Member of Malaysian Institute of Accountants. He obtained his Bachelor's Degree in Accounting from University of Central England, Birmingham, UK after graduating with a Diploma in Accountancy from Universiti Teknologi MARA. He has experience in the areas of accounting, auditing, operations, finance and corporate services.
He started his career as an Internal Auditor at Land & General Berhad and he was exposed to among others to the property development, construction, furniture, education and timber industries. Subsequently he moved to Tractors Malaysia Berhad and Business Focus Group. Previous positions held by him include Project Accountant and International Operations Manager.
Dr. Mohd Helmi Ismail - MBA, MD
Dr. Mohd Helmi Ismail has been a Medical Director for PMCare since 1999. He is a medical doctor and holds a Masters Degree in Business Administration. He underwent a Masters programme in Ophthalmology (Surgery) for 2 years from 1985 to 1987. Dr. Helmi served the Kuala Lumpur General Hospital for 2 years from 1983 to 1985 before becoming a lecturer in Universiti Kebangsaan Malaysia Medical Faculty for 2 years from 1985 to 1987. Subsequently, Dr. Helmi became a partner in one of the private general practitioner clinics and as today still practicing from time to time to ensure that he keeps abreast with the latest medical technology that keeps on evolving.
Dr Helmi is instrumental in the setting up of the medical management department of PMCare, especially in the documentation of the recommended standard of practice in the treatment of PMCare's members. He also trains the Claims department staff in processing the medical bills from various medical providers to ensure that all the relevant data from the claim forms are captured by the relevant staff. He currently also lectures post-graduate students at Universiti Kebangsaan Malaysia (Master in Community Health - Health Administration) and undergraduates at Universiti Teknologi MARA (Bachelor in Health Administration).
Saifuzzaman Aminudddin - DIB
General Manager - Claims
Saifuzzaman Aminudddin is the General Manager, Claims and has been with PMCaresince 1998. He graduated with Diploma in Banking from Universiti Teknologi MARA in 1987. He is a versatile and very experienced member of PMCare. After completing his studies in banking, he started out and served as an audit firm as an audit assistant in a public accounting firm. Subsequently, he moved on to the Ministry of Health, the Prime Minister's Department and Telekom Malaysia Berhad.
Prior to joining PMCare, Saifuzzaman was the Assistant Manager of Corporate Communications with EPE Power Corporation Berhad for 2 years. Currently, he supervises the day-to-day operations of the Claims department which also include liaison work with the insurance companies or underwriters.
Noor Hisyam Mohd Ghazali - MCSE, LLB (Hons)
General Manager – IT
Noor Hisyam Mohd Ghazali is the General Manager, IT and has been with PMCaresince 1998. He is a Microsoft Certified System Engineer (MCSE). He graduated from International Islamic University Malaysia with LLB (Hons). His interest and experience in the information technology began during his university days, when he started his own company doing computer assembly and servicing.
Noor Hisyam plays an active role in the development and maintenance of the Company's internal application software, MiX and web-browser application, Mediline™. Both applications are the backbone for the entire business and operations of PMCare.
Amri A. Rahman - B.SC(Hons) U.M
General Manager – Operations
Amri A.Rahman is a General Manager, Operations and has been with PMCare since 1998. He graduated from University Malaya with a BSc (Hons) in Ecology. Amri has vast experience in the services industry. In his current position, he supervises the day-to-day operations of the Member Support Unit which is operating 24 hours careline center, Providers Network Unit and Enrolment Unit. Operations department is one of the biggest departments and the backbone for PMCare.
Previously he served Singer (M) Sdn Bhd as an Internal Auditor from 1986 to 1992 before joining Rediffussion Consumer Electronics Sdn Bhd as a District Manager for 5 years until 1997
Dato' Mohd Nazmi Abdul Rahman - PJK, BBA
General Manager - Marketing Services
Dato' Mohd Nazmi Abdul Rahman, General Manager, Marketing Services joined PMCare in 2002. He graduated from University of Newcastle. He has worked mainly as a marketing person during his entire working career and has vast experience in servicing corporate clients. He served Komtel (M) Sdn Bhd as Sales Executive from 1990 to 1991 before joining Telekom Publications (M) Sdn Bhd for 6 years from 1991 to 1997. From 1997 to 2000, he had worked in two IT companies namely Paradigm Info-System (M) Sdn Bhd and Alami Group of Companies.
In year, 2000 he joined ING Insurance Berhad as Sales and Marketing Manager - Corporate Employee Benefits which is involved in the same business as PMCare. Besides marketing the PMCare's product and services, Dato' Mohd Nazmi also oversees for the Accounts Relationship Managers who provide quality services to all our corporate clients and members under our healthcare management programme.
Huzainah Hussin - CA(M), BA Accountancy, UiTM
General Manager - Finance
Huzainah Hussin is the General Manager, Finance and has been with PMCare since 1996. She holds a Bachelor's Degree (Hons) in Accountancy from UiTM. She is a Chartered Accountant and a member of the Malaysian Institute of Accountants. Prior to joining PMCare, she worked as an auditor with Messrs SJ Grant Thornton (Chartered Accountants).
She was responsible in the setting up and the implementation of PMCare's computerized accounting systems, standard operating procedures, and the integration with the Company's internal application system called MiX. Currently, she supervises the day-to-day operations of Finance Department and all financial matters and risk management of the Company.
Salleh Dahlan - Dip Business Studies, UiTM
General Manager - Client Services
Salleh Dahlan is the Assistant General Manager, Client Services Department and he has been with PMCare since 2007. He graduated with Diploma in Business Studies from UiTM in 1984. He started his career in the finance industry and became a branch manager at the age of 26. He had vast experiance in marketing, credit and branch operations before being promoted as the Head of Islamic Banking Unit of Hong Leong Finance Berhad in 1992.
In 1994, he moved into the manufacturing sector as a Senior Finance Manager in one of the subsidiary of a PSCI Bhd (a public listed company) and subsequantly promoted as a General Manager specializing in International Market. In 2002, he joined a diversified group of L&G Bhd's subsidiary, involving in construction, manufacturing and trading as General Manager of Finance. Salleh then left to become as Associate Consultant with Kheri-y Capital Sdn Bhd in 2005.
Dr Jasman Haris - MSSB
Assistant Medical Director, Medical Services
Dr Jasman Haris is a medical doctor who graduated from the established Monash University Australia, and was also trained at various hospitals in Melbourne, Australia. He came back to Malaysia to serve as a medical officer in Hospital Putrajaya from 2010 to 2012, before deciding to join the administrative side of medicine, in which he chose the healthcare insurance industry. His first experience in this industry was with another TPA, in which he started off as a medical officer, and was subsequently promoted to become the Head of Healthcare Provider Network Department due to his diligence and fast adaptability.
Now, with years of experience, Dr. Jasman is very well verse and proficient in this industry, and is able to adapt with the ever changing landscape of the healthcare insurance industry. He is responsible to oversee all the medical aspects pertaining to healthcare group insurance, and also responsible to connect and maintain good relationships with all the healthcare providers all over Malaysia.
- We are the pioneer managed care organisation ("MCO") in Malaysia having started our business since 1995. We now operate from our own office premise located at USJ 21 in Subang Jaya. Currently we have more than 250 employees. Our strength is in third party administration or business process outsourcing ("BPO") as most parties refer to, which is the subset of an MCO
- We are the first BPO provider specialising in management and administration of our corporate clients' medical benefit programmes extended to their employees and eligible dependents. Currently we are the only MCO in Malaysia that have been awarded the prestigious MS ISO 9001:2008 certificate by Certification International (UK) Ltd. This award is an endorsement for our quality management system that conforms to the international standard to meet the ever increasing demand of our customers.
- We have a large and solid membership base of more than 650,000 members. Some of our major clients are Telekom Malaysia Berhad, Tenaga Nasional Berhad, CIMB, Khazanah Nasional, UMW Group of Companies, Sapura Group of Companies, Pos Malaysia and Lembaga Tabung Haji.
- We have an extensive network of about 3,000 GP clinics, hospitals and medical centers located throughout Malaysia. We are the only MCO in Malaysia to implement on-line real-time verification of members when we install in all of our panel GP clinics a dual purpose card reader which can read the MyKad and the Smart Card. Once services are provided by the GP clinics, they can submit their medical claims to us within 3 working days of the date services rendered.
- More than 2700 of our GP clinics throughout Malaysia are already on-line (broadband either Streamyx or Unifi or other broadband service provider) with us through the Internet which is called Mediline™. Whilst on-line, the GP clinics can carry out validation process and subsequently submit their claims to us through the Internet.
- We are the preferred MCO by the GP clinics because we pay them 'as charged'. We do not impose any limits on the medical charges but instead review them to ensure that the same are justifiable.
- We have flexible programmes that our corporate clients could choose from. Our flexible programme includes managing your healthcare programme on a third party administration basis where you bear your own medical expenses or a programme which is insured fully or partially. Further, the chosen programme can either be an 'Open Access' where the member is allowed to visit any of the GP clinics within the panel or the 'Limited Access' where the visits are either limited to a selected GP clinics within the panel or limited by the number of visits or RM entitlement per annum or all of them. Alternatively, you may want to impose a co-payment system where the employee pays a portion of the medical expenses incurred by them. Our internal application software called Medicare Integrated Information Exchange or MiX is very flexible and robust that it can manage and administer various combinations and/or permutations of benefit entitlements.
- We have invested heavily on our IT for both hardware and software. Our backbone applications software, which is called MiX was first designed and developed by us in 1996 and is now in the 10thgeneration having gone through various improvements.
- We are not owned by any insurance company. Therefore, we can work with any insurance company nominated by our clients.
- We have collaborated with Diners Club International whereby certain categories of members are issued with Diners Club card for hassle free access to medical care at medical centers and private hospitals worldwide.
- Recently, we have formed an arrangement with 5 main medical provider groups in Malaysia namely KPJ, Pantai, Gleneagles, SJMC and Prince Court and introduced PMCare Premier Card to our selected members. The cardholders are accorded with VIP treatments at those hospitals.
We are dedicated towards quality and continuous improvement for both customers and employees through innovative process development, training and measurement of customer and employee satisfaction. In year 2002, we were awarded the ISO 9001:2000 certification and later was upgraded to ISO 9001:2008 in 2009. We are the first and the only MCO in Malaysia to be awarded the ISO 9001:2008 certification. The award of such certificate represents a tangible recognition and assurance of our consistency in providing quality services to meet the ever increasing demands of our customers through the development, implementation and maintenance of a quality management system that conforms to the international standard.