NHCPA to launch class action suit against medical aid schemes Following the release of the Section 59 Investigation Panel interim report. The National Health Care Professionals Association (NHCPA) says it will launch a class action lawsuit against medical aid schemes following the release of the Section 59 Investigation Panel interim […]
As per communique from GEMS (SAPPHIRE & BERYL) 2016 Tariffs 3. Tariff changes for 2016Please be advised of the following changes for 2016: An increase of 5.5% in professional fees for doctors participating in the GEMS FP network. Kindly note that with effect from 1 January 2016, the following fees and tariffs will be applicable […]
Should GEMS Patients be Treated With Circumspection? GEMS MEMBERS TO FEEL THE PAIN Unlike other medical schemes, it has never made use of the underwriting provisions in the Medical Schemes Act designed to protect schemes from “anti-selection”, a phenomenon in which people only join up when they get sick or anticipate big health bills. The […]
Please be advised that since 1 January 2016 GEMS has been processing claims via Medikredit. New submitting codes for the submission of dispensing doctor claims have been assigned and have been updated in the Medprax data files. Please note the Dispensing fee for Gems SEP and Non-SEP items is as follows: Amount Range […]
As per communique from GEMS (RUBY EMERALD ONYX) 2016 Tariffs 3. Tariff changes for 2016 Please be advised of the following changes for 2016: An increase of 5.5% in professional fees for doctors participating in the GEMS FP network. The following fees will be applicable to REO network doctors in 2016: GEMS REO FP network […]
Dental Benefit Changes Below is a summary of the dental tariffs and managed care protocols for 2015 that are included in the 2015 Dental Provider Guide. Tariffs and Benefits for 2015: Tariffs: A tariff increase of 6% on all dental procedures for contracted (Network) dental providers and 3.8% for non-contracted providers from 1 […]