CAMAF 2014 Year End Changes

CAMAF:

1. IMMUNISATION BENEFITS FOR 2014

SCHEME/PLAN IMMUNISATION MAX

ALLIANCE R3800.00 per beneficiary per annum.

DOUBLE PLUS

R1890.00 per Adult per annum (22 years and older)

R3150.00 per Child per annum (0 – 21 years)

VITAL R1260.00 per beneficiary per annum.

ESSENTIAL PLUS R1260.00 per beneficiary per annum.

FIRST CHOICE R1260.00 per beneficiary per annum.

NETWORK CHOICE R1260.00 per beneficiary per annum.

2. ACUTE MEDICINE BENEFIT CHANGE:

Effective 1 January 2015, 2nd and 3rd line anti-depressants, inhalers and Nexiam 40mg will be allowed 3 fills from the Acute/Savings

benefit. Rejection RMR 558 “Individual Protocol Quantity Exceeded” will be returned to the provider on the 4th fill if these items

have not yet been authorised on Chronic.

KEYHEALTH:

1. CHRONIC BENEFITS FOR EQUILIBRIUM PLAN MEMBERS

Effective 1 January 2015, the following Chronic conditions will be covered for authorised KeyHealth Equilibrium option members. A

10% co-payment will apply. An additional 30% co-payment will apply if dispensed by a non-DSP pharmacy.

Allergic Rhinitis (Patients under age 21)

Acne (Patients under age 21)

Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) (Patients under age 21)

2. PRE-NATAL VITAMIN BENEFITS

In 2015, based on registration on the program, pre-natal vitamins, to the value of R1500.00 per pregnant female (for the duration of

the pregnancy) will be covered from the Health Booster benefit.

3. HEALTH ASSESMENT BENEFIT INCREASE

Effective 1 January 2014 reimbursement of KeyHealth Health Assessment tests submitted on the customised tariff code indicated in

the table below will increase to R110.00

NAPPI CODE DESCRIPTION PRICE

716769

Blood Pressure Measurements

R110.00

Health Assessment – Blood Glucose Screening (finger prick)

Health Assessment – Cholesterol Screening (finger prick)

Health Assessment – Body Mass Index

Phlebotomy for PSA test

 

Brought to you by: Medinol Medical Billing and Claims Software

 

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About Medinol:
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, control your outstandings, 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:

medical billing software

 

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

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