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Afrox Medical Scheme Amalgamation

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Dear Trading Partner and Practice Manager
Afrox Medical Scheme will be amalgamating with Discovery Health Medical Scheme from 1 May 2014
We want to let you know that the members of Afrox Medical Scheme will move to the Discovery Health Medical Scheme (DHMS) from 1 May 2014. The destination remains the same as current.
Claim submission information
Claims with a service date from 1 May 2014
Please start sending claims to Discovery Health using these members’ new Discovery Health Medical Scheme membership numbers. They will receive their membership cards during the first or second week of May 2014.
Claims with a service date before 1 May 2014
Please finalise all reversals of claims with a service date up to 30 April 2013 for Afrox Medical Scheme.
Claims with a service date before 1 May 2014 must still be submitted to the administrator (Metropolitan Health) for processing.
Afrox Medical Scheme will not accept any claims with service dates from 1 January 2014.
Please note that the information contained in this communication on the proposed amalgamation of Afrox Medical Scheme and Discovery Health Medical Scheme is subject to the Council for Medical Schemes’ approval of the transaction.
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HPCSA investigating doctors issuing false Sick Certificates

HPCSA investigating doctors issuing false Sick Certificates

False medical certificates issued by corrupt doctors are costing the economy more than R12bn annually and have resulted in an investigation by the Health Professions Medical Council of SA (HPCSA).

The New Age reports that the HPCSA confirmed that it was investigating 50 doctors for issuing fraudulent sick notes.

Gauteng leads in sick note fraud with 25 doctors under investigation while the Western Cape has 19 cases and KwaZulu-Natal has three. The Gauteng Department of Health was unable to comment on the matter.

A report by Occupational Care South Africa (Ocsa), a private workplace health and wellness management company, said that without active management, a single day’s absence can cost a company an amount equivalent to three days salary. Ocsa data also shows that on average between 15% and 30% of staff are absent on any given day. It said that two-thirds of employees who fail to show up at work are not physically ill.

A human resources consultant, Jonathan Ndlovu, said a high percentage of employees appear to be faking illness. “It’s said that more than 40% of sick notes are handed out without a diagnosis. In most cases people who buy these are either unhappy or struggling to cope at work,” Ndlovu said.

 

Original article

Schemes Administered by Discovery

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Medical Aids or Schemes Administered by Discovery Health

ANGLO MEDICAL SCHEME
ANGLOVAAL GROUP MEDICAL SCHEME
BMW EMPLOYEES MEDICAL AID SOCIETY
DISCOVERY HEALTH MEDICAL SCHEME
FOSCHINI GROUP MEDICAL SCHEME
LA HEALTH
LONMIN MEDICAL SCHEME
MMED OPTION OF THE NASPERS MEDICAL FUND
NASPERS MEDICAL FUND
QUANTUM MEDICAL AID SOCIETY
REMEDI MEDICAL AID SCHEME
RETAIL MEDICAL SCHEME
TSOGO SUN GROUP MEDICAL SCHEME
UNIVERSITY OF KWAZULU NATAL MEDICAL SCHEME

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Celestone Soluspan – change in NAPPI code

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Celestone Soluspan – change in NAPPI code

 

Date: 29 October 2018

 

Celestone Soluspan 2ml

Please take note of the change in NAPPI code for the below product, as requested by the Supplier.

The new NAPPI will be active from 14 June 2017, and the old NAPPI will be discontinued on 30 June 2017.

SUPPLIER: MSD (Pty) Ltd

CHANGED DATE: 1 July 2017

DETAIL TABLE

Product Description Celestone soluspan 3mg/ml vial 2ml

Old NAPPI Code 711231001

Old pack size 2 ml

New NAPPI code 713171006

New pack size 1 unit

Should you require any further information about this change, please contact the supplier directly.

Brought to you byMedinol Medical Billing & Claims

 

MediSwitch Extended Support Hours

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Dear Valued Client,

At MediSwitch, we understand that our clients’ working hours are different. As such we are pleased to let you know that since 1 September 2016, our Contact Centre has been open from 7am to 6pm during weekdays and 8am to 1pm every Saturday.

Should you require any assistance, feel free to call our Contact Centre on 0800 703 111. Alternatively, you can send an email to support@mediswitch.co.za and we will get back to you as soon as possible.

Kind regards,
MediSwitch Support

ICD-10 Rejections for Age and Gender validations

ICD10 IMPLEMENTATION:

In order to be fully compliant with the ICD-10 implementation plan as outlined by the National ICD-10 Task Team,

stakeholders must have successfully implemented Phase 3 and Phase 4.1 by the 1

Phase 3 (already implemented):

Switchboard: 011 770 6000

Call Centre: 0860 932 273

Website: www.medikredit.co.za

2nd Floor President Place,

Cnr Jan Smuts Avenue & Bolton Road,

Rosebank, Johannesburg, 2196

Directors: Dr S C P Belamant; A Keschner; H G Kotzé

ectors: Dr S C P Belamant; W J du Plessis; H G Kotzé

Switchboard: 011 770 6000

Call Centre: 0860 932 273

st

of July 2014.

All health care providers are required to submit claims with complete codes (3rd, 4th or 5th character codes,

as appropriate). The validation process for primary and secondary codes continues during this phase.

Phase 4.1 to be implemented on 1 July 2014:

Rejections for Age and Gender validations as contained in the Master Industry Table (MIT) will be

implemented on the 1st of July 2014.

Please note that the Task Team has agreed to defer the validation and rejection of Paediatrician claims

(practice type 32 and 33) for the ICD-10 age and gender edits from 01 July 2014. MediKredit therefore will

not apply these changes to discipline types 32 & 33 effective 1st of July 2014.

RMR Codes

2103 – Diagnosis is invalid for the patient’s gender

2102 – Diagnosis is invalid for the patient’s age

4336 – Diagnosis is for Age younger than 19

4335 – Diagnosis is for Age 19 years or Older

This will only affect claims from service date of 01/07/2014. Claims before the 1st of July will not be affected.

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