GEMS REO GP Network 2013 Dispensing Fees

Dear Healthcare Professional, As a dispensing GEMS Network doctor please apply the following dispensing fee calculation for medicine which you dispense to the GEMS REO members: Single Exit Price (SEP) incl VAT Maximum Dispensing Fee (MDF) excl VAT <R90 30% of SEP >R90 R27 Note:1. As a participating GEMS REO GP Network doctor you agree not to charge our members …

2015 Momentum Health Dispensing Rates

As far as other procedures (excl consultations) are concerned Momentum Health will be increasing the general scheme rate by 5.5%.   This increase will be applicable on the current rate payable for procedures (2014).   Dispensed medicines and consumable products used as part of in-room procedures will be reimbursed as follows:   ·    All scheduled consumable products (schedule 0 to 8) …

NHI Whitepaper approved

Cabinet has approved the White Paper on the National Health Insurance (NHI) to be gazetted as a policy document. Cabinet on Thursday said that the White Paper takes the country closer to ensuring all South Africans have access to healthcare, irrespective of their socio-economic status. The NHI is a health financing system that is designed to pool funds to provide …

Discovery Chronic Disease 0199

How Discovery pays for 0199   From 4 September 2015, Discovery Health will be automating the payment of code 0199 for the reimbursement of all confirmed and approved PMB conditions on the Chronic Disease List that meet the legislative requirements for funding.   (Code 0199 – Completion of chronic medication forms by medical practitioners with or without the physical presence …

Problem with Discovery Medical Aid Accounts?

ACCOUNTS ACCEPTED BY MEDISWITCH, REJECTED BY DISCOVERY It has come to our attention that this has been happening at certain practices since 15 March 2011. Please check your claims:- some doctors and dentists have since not received any payments from Discovery!!! Now, more than ever do the following: STOP submitting Discovery claims via EDI until the (referring doctor) problem has …