Dear Electronic Switch Houses/Bureau’s
THEBEMED MEDICAL SCHEME CHANGES 2018
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.
ThebeMed Medical Scheme Tariff will increase with 6% for 2018.
Managed Care Third Parties:
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.
The scheme will continue to use DENIS for dental management and Preferred Provider Negotiators (PPN) for optical management for the claiming year of 2018.
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