Mamoth Health Medical Scheme

Mamoth Health Medical SchemeMamoth Health Medical Scheme

NEW MAMOTH HEALTH SCHEME INFORMATION

Mamoth Health, a self administered scheme, will be processing medicine claims via MediKredit with effect from 1 February

2012. New acute and chronic option codes as indicated in the summary table have been assigned for the processing of all

plans.

 

2. HEALTHNET

2.1 Claims:

 

a) Claims should be submitted via HealthNet

 

2.2 Validation:

 

HealthNet will validate:

a) Membership number

b) Date of birth

c) Dependent Code

 

2.3 Networks:

 

HealthNet will accommodate all networks as agreed to with the scheme.

Mamoth Health Medical SchemeMamoth Health Medical Scheme
 

2.4 Markup & Dispensing Fee

 

a) Schedule 0 and nonscheduled items calculated on published wholesale price : R0 to R78.00: 34.20 %, Max R26.68 (Incl.

VAT)

b) Schedule 1 to 7 calculated on Single Exit Price: R0 to R78.00: 34.20 %, Max R26.68 (Incl. VAT)

 

2.5 Membership Number

 

a) Total length: 9 digits

 

2.6 Stale Claim Period

 

120 Days

 

2.7 Online Reversal Period

 

120 Days

 

3. PAYMENT INFORMATION

 

MediKredit will be paying providers on behalf of the scheme.

 

SUMMARY OF SCHEME RULES

 

PLAN/OPTION OPTION CODE SURCHARGE

MMAP/REF

PRICING or URP

 

MAMOTH HEALTH DD ACUTE MAHDA 612661 * Check HealthNet ST Response No

MAMOTH HEALTH DD CHRONIC MAHDC 612688 * Check HealthNet ST Response No

 

The Fam& Authcheck functionality will be available on these options.

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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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Comments 6

  1. I need the contact number for Mamoth Health to obtain authorisation as well as the destination code where the claims are to be submitted to.

  2. Please contact me in connection of outstanding claims and also the e-mail adres for MAMOTH HEALTH.

    THANK YOU FOR YOUR URGENT REPLY

    SUSAN DERCKSEN

  3. Post
    Author

    We would suggest that you contact Mamoth Health directly. You should have the telephone number from the back of the membership card that was presented at your rooms. All the best.

  4. I need a email address for follow up on outstanding radiology accounts since January 2016. We are not able to get thru to your telephone nr 00266 22322383. This claim is long overdue and I need urgent feedback, otherwise the member will kept responsible to settle this account before end of May 2016. Thanks Hanna.

  5. Post
    Author
  6. Good Day,
    I have EDI-ed and sent e – mails repeatedly to Mammoth Health Lesotho. Unfortunately we have had no response whatsoever. This has been since February 2016. We are not able to get through to your number 0026622322383. These are outstanding Speech Language and Feeding Therapy accounts for a patient seen in hospital. Kindly provide the correct e – mail address so that tyhe member will not be liable for the payments. The claim is long overdue and I need urgent feedback.

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