Medical Aid EDI Codes – 2016/02

MEDICAL AID EDI CODES AS AT FEB 2016

Below are the latest Medical Aid activation and destination codes.

 
 

MEDINOL USERS: OMIT THE “P” –  Enter Only The Numeral

 

VERY IMPORTANT
The media used by MediSwitch to submit your claims to the Medical Aid Schemes are Real-Time, EDI (electronic) or Printed Statements.

PLEASE NOTE: An * (Asterisk) in front of a Code indicates a change to an existing scheme or a new scheme on the list. 

QEDI CodeMediSwitch Destination CodeScheme NameAdministrator Name
460PEMED00051 DOCTOR HEALTH1 Doctor Health
027PSHAE0000AECI MEDICAL AID SOCIETYMedscheme
215PAMAS0002AECI MEDICAL AID SOCIETY VALUE OPTIONUniversal Healthcare Administrators (Pty) Ltd.
290PABRO0001AFA BROADREACHMedscheme
304PACOR0001AFA CORPORATEMedscheme
276PAHEA0001AFFINITY HEALTHPan African Managed Care (Pty) Ltd
224PMSAM0002ALLIANCE MIDMED MEDICAL SCHEMEPrivate Health Administrators (Pty) Ltd
037PNPAM0000ANGLO MEDICAL SCHEMEDiscovery Health Administrators
036PDIAV0000ANGLOVAAL GROUP MEDICAL SCHEMEDiscovery Health Administrators
*771PAMIN0002ASTERIO MEDICAL INSURANCEAsterio Medical Insurance
042PBKAC0000BANKMED MEDICAL SCHEMEDiscovery Health Administrators
043PMSBR0000BARLOWORLD MEDICAL SCHEMEMedscheme
733PBCIM0001BCIMA (BUILDING AND CONSTRUCTION INDUSTRY MEDICAL AID FUND)Universal Healthcare Administrators (Pty) Ltd.
045PBEBE0000BESTMED MEDICAL SCHEMEBestmed
048PMSBW0000BMW EMPLOYEES MEDICAL AID SOCIETYDiscovery Health Administrators
595PBSBO0000BOMAIDBOMaid Medical Aid
050PMSBS0000BONITAS MEDICAL FUNDMedscheme
056PBKAJ0000BP SOUTHERN AFRICA MEDICAL AID SOCIETYMetropolitan Health Group
593PINPE0000BUILDING INDUSTRIES P.E.Industrial Council P.E.
079PCAAA0000CAMAFSanlam Health
052PCMPL0000CAPE MEDICAL PLANCape Medical Plan
561PCARE0006CARECROSSCarecross
389PCFDA0001CENTRE FOR DIABETES AND ENDOCRINOLOGY (CDE)Sanlam Health
009PIHCO0000COMMUNITY MEDICAL AID SCHEME (COMMED)Allcare Administrators (Pty) Ltd
129PSSCC0000COMPCARE MEDICAL SCHEMEUniversal Healthcare Administrators (Pty) Ltd.
454PCFIO0001COMPENSATION FUND (IOD)Compensation Fund (IOD)
704PCIOD0001COMPSOL (IOD CLAIMS)IOD Claims: Compsol
066PDBDB0000DE BEERS BENEFIT SOCIETYDe Beers Benefit Society
483PDSGM0004DEEP SOUTH GOLD MINEProvidence Health Risk Managers
406PDRCC0001DENTAL RISK COMPANYDRC Dental Risk Company
125PDHEA0000DISCOVERY HEALTH MEDICAL SCHEMEDiscovery Health Administrators
226PDOME0001DOMESTICARECarecross
289PEMCC0008EMERGING MARKET HEALTHCAREEmerging Market Healthcare
*752PEGIN0001ENABLEMED GETSURE INSURANCEEnablemed
269PBKAI0000ENGEN MEDICAL BENEFIT FUNDMetropolitan Health Group
516PEMED0006ESSENTIAL MEDEssential Med
*690PEGMI0001EVANDER GOLD MINEProvidence Health Risk Managers
160POPLA0001FEDHEALTH MEDICAL SCHEMEMedscheme
779PFISH0001FISHING INDUSTRY MEDICAL SCHEME (FISHMED)Metropolitan Health Group
489PFAAW0001FOOD AND ALLIED WORKERS HEALTH BENEFIT FUNDEminent Wealth Consult Pty Ltd
083PBKAL0000FOSCHINI GROUP MEDICAL SCHEMEDiscovery Health Administrators
470PFURN0001FURNMEDEminent Wealth Consult Pty Ltd
518PGMSC0001GENESIS MEDICAL SCHEMEGenesis Medical Aid
381PGSWA0001GETMED AFRICA (SWAZILAND)GETMED Swaziland
*504PGETS0001GETSAVVIBlackbird Group (Pty) Ltd
181PXTRA0001GLENCORE MEDICAL SCHEMEMedscheme
363PGARR0000GOLDEN ARROW EMPLOYEES MEDICAL BENEFIT FUNDMetropolitan Health Group
875PGEMS0001GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS EMERALD OPTION)Metropolitan Health Group
925PGEOP0001GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS ONYX OPTION)Metropolitan Health Group
926PGROP0001GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS RUBY OPTION)Metropolitan Health Group
259PSTGR0000GRINTEK ELECTRONICS MEDICAL AID SCHEMEUniversal Healthcare Administrators (Pty) Ltd.
173PGCOP0003GROOMS COVER OPTIONEnablemed
597PIDHA0000HAIRDRESSING SICK BENEFIT FUND CAPE TOWNHairdressing Sick Benefit Fund
870PHARM0001HARMONY HEALTH SERVICESProvidence Health Risk Managers
472PHEAL0002HEALTH4MEMomentum Medical Scheme Administrators (MMSA)
684PHHMA0001HERITAGE HEALTH MEDICAL AID FUNDJanus Investments (Pty) Ltd
444PHMSC0001HORIZON MEDICAL SCHEMEMedscheme
523PTHHM0000HOSMED MEDICAL AID SCHEMEThebe YaBophelo Healthcare
439PIMPL0001IMPALA MEDICAL PLANProvidence Health Risk Managers
364POMIM0000IMPERIAL GROUP MEDICAL SCHEMEMetropolitan Health Group
495PWCAS0001JHB METROPOLITAN COUNCIL (IOD) AND CITY OF TSHWANE (IOD)WCA Workers Compensation Assistance cc
510PMUNI0000KEYHEALTHProfessional Medical Scheme Administrators (PMSA)
525PLHEA0001LA HEALTHDiscovery Health Administrators
099PMSLI0000LIBCARE MEDICAL SCHEMELiberty Health Administrators
008PLBLU0001LIBERTY BLUE MEDICAL SCHEMELiberty Health Administrators
101PLIPS0000LIBERTY HEALTH MEDICAL SCHEMELiberty Health Administrators
945PLMSC0001LONMIN MEDICAL SCHEMEDiscovery Health Administrators
302PMCAP0002MAKOTI COMPREHENSIVE AND PRIMARYEnablemed
104PNMMD0000MALCOR MEDICAL SCHEMEDiscovery Health Administrators
255PMODD0001MALCOR OPTION DEnablemed
247PMHPL0002MAMOTH HEALTH PLANMamoth Employee Benefits (Pty) Ltd
598PMASC0000MASCA ZIMBABWEMASCA Zimbabwe
038PMSSS0000MASSMART HEALTH PLANUniversal Healthcare Administrators (Pty) Ltd.
180PDCME0003MB MEDMedscheme
256PMGFM0001MEDIHELPMedihelp
265PMSDI0000MEDIMED MEDICAL SCHEMEProvidence Health Risk Managers
168PMSFU0001MEDIONE SICK FUNDOneplan Medical Insurance
250POMDP0000MEDIPOS MEDICAL SCHEMEMetropolitan Health Group
111PMSMS0000MEDSHIELD MEDICAL SCHEMEMedshield Administrators
*754PMEDS0003MEDSTART MEDICAL SCHEMEMedStart
121PMMSC0000METROPOLITAN MEDICAL SCHEMEMetropolitan Health Group
362PMMSC0001MMED OPTION OF THE NASPERS MEDICAL FUNDDiscovery Health Administrators
237PMHAF0001MOMENTUM HEALTH AFRICAMomentum: HDS Medical Management
822PMHEA0007MOMENTUM HEALTH MEDICAL SCHEMEMomentum Medical Scheme Administrators (MMSA)
940PMHCA0001MOTO HEALTHCAREMomentum Medical Scheme Administrators (MMSA)
292PMINT0001MSO INTERNATIONALMSO
206PMSAS0000NAMIBIA HEALTH PLANMedscheme Namibia
600PMSAU0000NAMIBIA IND MEDICAL AIDMedscheme Namibia
512PNSNP0000NASPERS MEDICAL FUNDDiscovery Health Administrators
010PNWFH0001NBCRFLI WELLNESS FUND HEALTH PLANPan African Managed Care (Pty) Ltd
016POMNE0000NEDGROUP MEDICAL AID SCHEMEMedscheme
067PNPMS0000NETCARE MEDICAL SCHEMEPrimeMed
624PNSBS0001NUFSWSA SICK BENEFIT SOCIETYEminent Wealth Consult Pty Ltd
012POMOL0000OLD MUTUAL STAFF MEDICAL AID SCHEMEMedscheme
468POPMI0001ONEPLAN MEDICAL INSURANCEUniversal Healthcare Administrators (Pty) Ltd.
142PNASE0000OPMEDOpmed (NIA)
143PMSPA0000PARMED MEDICAL AID FUNDMedscheme
146PNMPS0000PG GROUP MEDICAL SCHEMEMetropolitan Health Group
376PDEAO0000PICK N PAY MEDICAL SCHEMEMetropolitan Health Group
266PMSAP0001PLATINUM HEALTHPlatinum Health
219PMHPO0001POLMEDMedscheme
703PPIOD0001POLMED (IOD CLAIMS)Metropolitan Health Group
417PPAEC0001PPN AECIMedscheme
426PPBAN0001PPN BANKMEDDiscovery Health Administrators
432PPCAR0001PPN CARECROSSCarecross
457PPMED0018PPN MEDIMEDProvidence Health Risk Managers
419PPPOL0001PPN POLMEDMedscheme
642PPCUR0001PRIME CUREPrime Cure
154PPFPO0000PROFMEDProfessional Medical Scheme Administrators (PMSA)
474PPROT0001PROTEKTAProvidence Health Risk Managers
162PQMAS0002QUANTUM MEDICAL AID SOCIETYDiscovery Health Administrators
818PRMAS0001RAND MUTUAL ASSURANCERand Mutual Assurance
607PRAWB0000RAND WATER MEDICAL SCHEMERand Water Board
645PRFMC0001REGULAR FORCE MEDICAL CONTINUATION FUND (RFMCF)Professional Medical Scheme Administrators (PMSA)
161PMSRM0000REMEDI MEDICAL AID SCHEMEDiscovery Health Administrators
257PRHMF0001RENAISSANCE HEALTH MEDICAL AID FUNDProsperity Health Namibia
061PBKAO0000RESOLUTION HEALTH MEDICAL SCHEMEAgility
608PREMT0000RETAIL MEAT TRADERetail Meat Trade
946PRMSC0001RETAIL MEDICAL SCHEMEDiscovery Health Administrators
581PTEMS0001RHODES UNIVERSITY MEDICAL SCHEME (RU MED)Providence Health Risk Managers
*780PRHSC0001ROSHMED HOSPITAL SCHEMERoshmed
179PMSBI0000SA BREWERIES MEDICAL AID SOCIETYMomentum Medical Scheme Administrators (MMSA)
176PMSAG0000SABC MEDICAL AID SCHEMEMedscheme
611PSAMW0001SAMWUMEDSAMWUmed
175PMSOI0000SASOLMED MEDICAL SCHEMEMedscheme
022PSMSC0003SEDMED MEDICAL SCHEMESEDMED Medical Scheme
004PSHSF0000SELFMED MEDICAL SCHEMESelfmed
188PGFHS0001SIBANYE GOLDProvidence Health Risk Managers
116PDIME0000SISONKE MEDICAL SCHEMEProvidence Health Risk Managers
178PSZWE0000SIZWE MEDICAL FUNDSechaba Medical Solutions
522PROSP0000SPECTRAMEDAgility
614PSPSB0000SPES BONASpes Bona
072PDEAC0000SUREMED HEALTHProvidence Health Risk Managers
240PMSSW0000SWAZIMEDMedscheme
769PTBEN0001THEBEMED MEDICAL SCHEMEThebe YaBophelo Healthcare
228PTIGE0000TIGER BRANDS MEDICAL SCHEMEUniversal Healthcare Administrators (Pty) Ltd.
003PBKTE0001TOPMED MEDICAL SCHEMEPrivate Health Administrators (Pty) Ltd
194PTRTR0000TRANSMED MEDICAL FUNDMetropolitan Health Group
229PTSPN0001TRANSMED STATE PLUS NETWORK OPTIONUniversal Healthcare Administrators (Pty) Ltd.
*778PTRUC0001TRUCAREUniversal Healthcare Administrators (Pty) Ltd.
944PTSGM0001TSOGO SUN GROUP MEDICAL SCHEMEDiscovery Health Administrators
869PUMSC0001UDIPAUdipa Medical Aid
920PUHMS0001UMVUZO HEALTH MEDICAL SCHEMEUmvuzo Health Medical Scheme
233PUHSA0001UMVUZO HEALTH STANDARD AND ULTRA OPTIONUniversal Healthcare Administrators (Pty) Ltd.
484PAUHE0001UNITY HEALTHAmbledown Financial services (Pty) LTD
198PMSUN0000UNIV OF WITWATERSRAND STAFF MEDICAL AID SCHEMEDiscovery Health Administrators
*566PUIPL0001UNIVERSAL HEALTH AND ACCIDENT PLANUniversal Healthcare Administrators (Pty) Ltd.
431PUHEA0001UNIVERSAL HEALTH WORKERS PLANUniversal Healthcare Administrators (Pty) Ltd.
197PMSAV0000UNIVERSITY OF KWAZULU NATAL MEDICAL SCHEMEDiscovery Health Administrators
286PWYMO0001WCMAS: YEBO MED OPTIONWitbank Coal Medical Aid Society
201PMKWC0000WITBANK COALFIELDS MEDICAL AID SCHEMEWitbank Coal Medical Aid Society
202PDIWO0000WOOLTRU HEALTHCARE FUNDMetropolitan Health Group
028PYARO0001YARONASAPS

MEDINOL MEDICAL BILLING | PRACTICE MANAGEMENT SOFTWARE

Medinol is one of the few purpose-built practice management application to meet the unique needs of independent private healthcare providers.

Today Medinol helps over 130 providers throughout South Africa run more efficient and profitable practices, while delivering outstanding patient care.

As an on-premise software, Medinol and the data it manages, is fully under your control. This enhances your independence and privacy: what happens in your rooms, stays in your rooms.

Medinol helps manage your patient information, generates your billings, submits your claims, controls your outstanding debtors, and get your accounts paid quickly.

Medinol has been in operation since 1984, demonstrating its proven efficacy.

Medinol’s mission is to help independent practices succeed in an ever-changing healthcare environment.

More information can be found at http://medinol.co.za.

Contact:

Fudley Bezuidenhout Pr.Eng.
Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

THEBEMED MEDICAL SCHEME CHANGES 2018

Dear Electronic Switch Houses/Bureau’s

THEBEMED MEDICAL SCHEME CHANGES 2018

Directors:

This letter serves as notification that Thebe Ya Bophelo Administrators and Providence Healthcare Risk Managers are merging on the 01st of January 2018. ThebeMed Medical Scheme will be moving to the Providence Healthcare Administration System as from the 01st of January 2018.

Please be advised that all future claims with a service date from 1 January 2018 onwards must be submitted to Providence Healthcare. All claims for 2017 and previous years must be submitted to Thebe Ya Bophelo Administrators, Thebe will continue to assess these claims on the MIP administration system till the end of April 2018.

ThebeMed Medical Scheme Options 2018:

The following Options are active for 2018 on ThebeMed Medical Scheme:

• Universal Option

Universal Efficiency Discount Option (EDO)

• Energy Core Network Option

• Energy Medium Network Option

• Energy Open Network Option

• Fantasy Option (New Savings Option)

Membership Card Files:

Providence will provide daily membership card files from the 01st of January 2018.

Scheme Increase:

ThebeMed Medical Scheme Tariff will increase with 6% for 2018.

Managed Care Third Parties:

Medicine Claims

Please be advised that all future claims with a service date from 1st of January 2018 onwards must be submitted to Providence for Medicine Claims and not to Mediscor PBM. All claims prior the 01st of January 2018 must be submitted to Mediscor PBM.

Dental Claims

The scheme will continue to use DENIS for dental management and Preferred Provider Negotiators (PPN) for optical management for the claiming year of 2018.

 

 

 

Brought to you by Medinol Medical Billing Software

Accredited Medical Scheme Administrators

Accredited Medical Scheme Administrators

Date: 29 Dec 2017

 

 

Organization NameStart DateExpiry DateContactAddressTelephoneWeb AddressView Conditions
AGILITY GLOBAL HEALTH SOLUTIONS AFRICA (Pty) Ltd (ADMIN: 3)Jun 04, 2012Jun 04, 2014GA RoperPO BOX 7687 CENTURION 00460126735499www.agilityghs.comView Conditions
ALLCARE ADMINISTRATORS (PTY) LTD (ADMIN: 2)Dec 01, 2012Nov 30, 2014Ms R van WykPO BOX 2650 RIVONIA 21280112906200www.allcare.co.zaView Conditions
BESTMED MEDICAL SCHEME (Self-Administered) (ADMIN: 62)Dec 06, 2012Dec 06, 2015Mr D Le GrangePO Box 2297 PRETORIA 00010860002378www.bestmed.co.zaView Conditions
CAPE MEDICAL PLAN (SELF-ADMINISTERED) (ADMIN: 50)Jun 30, 2012Jun 30, 2015MR D ShardlowPO BOX 966 PAROW 75000219378300www.cmp.co.zaView Conditions
De Beers Benefit Society (Self-Administered) (ADMIN: 57)Dec 09, 2013Dec 09, 2016Mr L CoetzeePO Box 1922 Kimberley 83000538073355NoneView Conditions
DISCOVERY HEALTH (PTY) LTD (ADMIN: 19)Dec 31, 2013Dec 31, 2015Dr Jonathan BroombergPO BOX 786722 SANDTON 21460115292000NoneView Conditions
ETERNITY PRIVATE HEALTH FUND ADMINISTRATORS (PTY) LTD (ADMIN: 10)Feb 14, 2013Feb 14, 2015Mr LJ NelPO BOX 2964 RANDBURG 21250117078400www.eternityhealth.comView Conditions
Food Workers Medical Benefit Fund (ADMIN: 63)Jun 27, 2013Jun 27, 2016Dr NS MatlalaPO Box 1067 PAROW 7499021 930 3550NoneView Conditions
MEDIHELP MEDICAL SCHEME (SELF ADMINISTERED) (ADMIN: 46)Oct 31, 2011Oct 31, 2014MR AO RIJNENPO BOX 26004 ARCADIA 00070123342346www.medihelp.co.zaView Conditions
Medscheme Holdings (Pty) Ltd (ADMIN: 21)Dec 31, 2013Dec 31, 2015Andre MeyerPO Box 1101 FLORIDA GLEN 1708011 6712288www.medscheme.co.zaView Conditions
METHEALTH (PTY) LTD (ADMIN: 18)Dec 31, 2013Dec 31, 2015Blum KhanPO BOX 4313 CAPE TOWN 8000021 480 4511www.mhg.co.zaView Conditions
METROPOLITAN HEALTH CORPORATE (PTY) LTD (ADMIN: 17)Jan 01, 2014Jan 01, 2016Blum KhanPO BOX 4313 8000021 480 4511www.mhg.co.zaView Conditions
MOMENTUM MEDICAL SCHEME ADMINISTRATORS (PTY) LTD (ADMIN: 13)Jan 25, 2013Jan 25, 2015Blum KhanPO BOX 4313 Cape Town 80000214804511www.momentum.co.zaView Conditions
PLATINUM HEALTH (SELF ADMINISTERED) (ADMIN: 53)Dec 10, 2012Dec 10, 2015WELCOME MBONISOPRIVATE BAG X82081 RUSTENBURG 02910145913069NoneView Conditions
PRIME MED ADMINISTRATORS (PTY) LTD (ADMIN: 64)Jul 25, 2013Jul 25, 2015Mr David de VilliersPrivate Bag X141 PRETORIA 0046012 665 8500NoneView Conditions
PRIVATE HEALTH ADMINISTRATORS (ADMIN: 11)Jun 04, 2012Jun 04, 2014MR R SOUTHEYPO BOX 343 WESTVILLE 36300312675000www.pha.co.zaView Conditions
PROFESSIONAL MEDICAL SCHEME ADMINISTRATORS (PTY) LTD (ADMIN: 37)Jun 06, 2013Jun 06, 2015Dr H Du Preez HoffmanPrivate Bag X1031 LYTTELTON 01400126794049www.profmsa.co.zaView Conditions
PROVIDENCE HEALTHCARE RISK MANAGERS PTY LTD (ADMIN: 22)Apr 07, 2012Apr 07, 2014M NEUBERTPO BOX 1672 PORT ELIZABETH 60000413954400NoneView Conditions
Rand Water Medical Scheme (Self-administered) (ADMIN: 56)Oct 29, 2013Oct 29, 2016Mrs M NYEMBEPO Box 1127 Johannesburg 20000116820911www.randwater.co.zaView Conditions
SAMWUMED (SELF-ADMINISTERED) (ADMIN: 55)Aug 20, 2013Aug 20, 2016Mr N NairPO Box 134 Athlone 7760021699004www.samwumed.orgView Conditions
SECHABA MEDICAL SOLUTIONS (PTY) LTD (ADMIN: 8)Dec 23, 2012Dec 23, 2014Mr Grant NewtonPO BOX 10436 JOHANNESBURG 2000011 353 0000www.sechabamedical.co.zaView Conditions
SEDMED (SELF-ADMINISTERED SCHEME) (ADMIN: 65)Dec 05, 2013Dec 05, 2016Mr A du PreezPO Box 468 BLOEMFONTEIN 9300(051)447-8271NoneView Conditions
STRATA HEALTHCARE MANAGEMENT (PTY) LTD (ADMIN: 68)Dec 05, 2013Dec 05, 2015Dr NS MatlalaPO Box 26004 ARCADIA 0007 NoneView Conditions
Thebe Ya Bophelo Healthcare Administrators (Pty) Ltd (ADMIN: 7)Jun 04, 2012Jun 04, 2014R LAIRDPO BOX 16144 DOORNFONTEIN 20280115448000www.tybhealth.co.zaView Conditions
UMVUZO HEALTH MEDICAL SCHEME (SELF-ADMINISTERED) (ADMIN: 51)Dec 10, 2012Dec 10, 2015JJ OOSTHUIZENPO BOX 1463 FAERIE GLEN 00430128450000NoneView Conditions
Universal Healthcare Administrators (Pty) Ltd (ADMIN: 5)Jun 05, 2012Jun 05, 2014Desmond Aubrey KerrPO BOX 1411 RIVONIA 2128011208-1381www.universal.co.zaView Conditions
V MED ADMINISTRATORS (PTY) LTD (ADMIN: 45)Apr 24, 2013Apr 24, 2015Ms Mbali KhumaloPO BOX 44741 CLAREMONT 77350216721198www.vmed.co.zaView Conditions
Witbank Coalfields Medical Aid Scheme (Restricted -Self-Administered) (ADMIN: 54)May 19, 2013May 19, 2016Ms R BooyensPO Box 26 WITBANK 1035013 6561407NoneView Conditions
 
 

MEDINOL MEDICAL BILLING | PRACTICE MANAGEMENT SOFTWARE

Medinol is one of the few purpose-built practice management application to meet the unique needs of independent private healthcare providers.

Today Medinol helps over 130 providers throughout South Africa run more efficient and profitable practices, while delivering outstanding patient care.

As an on-premise software, Medinol and the data it manages, is fully under your control. This enhances your independence and privacy: what happens in your rooms, stays in your rooms.

Medinol helps manage your patient information, generates your billings, submits your claims, controls your outstanding debtors, and get your accounts paid quickly.

Medinol has been in operation since 1984, demonstrating its proven efficacy.

Medinol’s mission is to help independent practices succeed in an ever-changing healthcare environment.

More information can be found at http://medinol.co.za.

Contact:

Fudley Bezuidenhout Pr.Eng.
Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

Discovery Health Subscription Increase 2018

Discovery Health Subscription Increase 2018

Date: 20 Sep 2017

With a flurry of new NHI regulations breaking ground in 2017, medical aid schemes in South Africa are under pressure with an uncertain future. However, one thing is always guaranteed – price increases.

Discovery Health has announced that customers can expect a rather large increase to contributions in 2018, with the weighted average coming in at 7.9% across its plans.

  • Executive and Smart plan options will be increasing at an average of 7.3%
  • Core and Saver plan options will increase at an average of 7.6%
  • Priority and KeyCare plan options will increase at an average of 8.3%

This increase is not as large as the jump seen in 2017 (where the average was 10.2%), but remains high above inflation, which is around 6% this year. However, Discovery maintains that the increase is below medical aid inflation – the indicator it uses to decided its price increases for medical aid schemes – which is estimated to be at 9% this year.

“Over the 12-month period of August 2016 to July 2017, average CPI was 5.93%. Using CPI + 3% as an indication of medical inflation, the average medical inflation over this period was 8.93%. Thus, the DHMS average increase of 7.9% is well within the medical inflation corridor of CPI+3%,” Discovery said.

The group said that its rates are currently 15.1% lower than its competitors, and it expects that this gap will widen in 2018.

Along with the price increases, Discovery Health clients can also expect enhanced offerings, it said, with improved maternity and child benefits, and extended international health coverage for members on the Executive scheme.

Other new benefits include over-the-counter cover for Schedule 0-2 medicines on the Smart plan, and increased limits on all benefits (in line with each individual plan-specific contribution increase).

The group will also introduce a new technology platform called DrConnect, which will allow members to connect directly with a network of health professionals from smart devices. The platform uses AI to connect 105,000 doctors with millions of patients around the world to answer health questions.

—->>> Read more

MEDINOL MEDICAL BILLING | PRACTICE MANAGEMENT SOFTWARE

Medinol is one of the few purpose-built practice management application to meet the unique needs of independent private healthcare providers.

Today Medinol helps over 130 providers throughout South Africa run more efficient and profitable practices, while delivering outstanding patient care.

As an on-premise software, Medinol and the data it manages, is fully under your control. This enhances your independence and privacy: what happens in your rooms, stays in your rooms.

Medinol helps manage your patient information, generates your billings, submits your claims, controls your outstanding debtors, and get your accounts paid quickly.

Medinol has been in operation since 1984, demonstrating its proven efficacy.

Medinol’s mission is to help independent practices succeed in an ever-changing healthcare environment.

More information can be found at http://medinol.co.za.

Contact:

Fudley Bezuidenhout Pr.Eng.
Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

Medical Schemes Administered by Medscheme

Medical Schemes Administered by Medscheme

Date: 19 September 2017

AECI Medical Aid Society

Barloworld Medical Aid

BMW Employees Medical Aid Society

Bonitas

Fedhealth

Glencore Medical Scheme

Government Employees Medical Scheme (GEMS)

Horizon Medical Scheme

Massmart Health Plan

MBMed Medical Aid Fund

Namibia Health Plan

Nedgroup Medical Aid Scheme

Old Mutual Staff Medical Aid Fund

Parmed Medical Aid Scheme

SABC Medical Aid Scheme

Sasolmed

Swaziland Medical Aid Fund (Swazimed)

University of the Witwatersrand – Johannesburg Staff Medical Aid Scheme

 

MEDINOL MEDICAL BILLING | PRACTICE MANAGEMENT SOFTWARE

Medinol is one of the few purpose-built practice management application to meet the unique needs of independent private healthcare providers.

Today Medinol helps over 130 providers throughout South Africa run more efficient and profitable practices, while delivering outstanding patient care.

As an on-premise software, Medinol and the data it manages, is fully under your control. This enhances your independence and privacy: what happens in your rooms, stays in your rooms.

Medinol helps manage your patient information, generates your billings, submits your claims, controls your outstanding debtors, and get your accounts paid quickly.

Medinol has been in operation since 1984, demonstrating its proven efficacy.

Medinol’s mission is to help independent practices succeed in an ever-changing healthcare environment.

More information can be found at http://medinol.co.za.

Contact:

Fudley Bezuidenhout Pr.Eng.
Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

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 co-payments over and above the above maximum dispensing fee.
2. For a copy of the 2013 formulary go to the GEMS website (www.gems.gov.za)
and click Healthcare Providers > ICD-10 Code/Formulary Check Service > 2013 REO
Comprehensive Formulary.

Should you have any further queries, please contact GEMS

Call Centre: 0860 00 4367 (GEMS)
Website: www.gems.gov.za
Email: enquiries@gems.gov.za

Yours sincerely,

GEMS Managed Care

 

To implement in Medinol Medical Aid Billing Software:

  1. Go into Medinol
  2. Select Process -> Command Prompt
  3. At the Command Prompt, enter SYSMAINT
  4. Adjust entries at the bottom of the first screen (note: use VAT INCLUSIVE FIGURES)
  5. Press Enter to get pass all the other screens.
  6. Enter EXIT once you are back at the command prompt
  7. Escape out of Medinol back to Windows, then re-enter Medinol for settings to take effect.

 

Problems? Email us on info@medinol.co.za