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Witbank Dosage Limit
DOSAGE LIMITS ON CODEINE CONTAINING PRODUCTS
In support of good clinical governance and to ensure clinically appropriate use of medication, effective 1 September 2016, Witbank Coalfields Medical Scheme will implement dosage limits to Schedule 1 to 3 Codeine containing products, submitted on the Acute options.
An accumulative dosage limit of 1 200mg of Codeine (across all the S1-S3 therapeutic classes containing Codeine) within a 30 days treatment cycle will be allowed.
For the period 1 September 2016 to 28 February 2017 when the dosage is exceeded a message will be returned to the PMS, warning that the member has exceeded the allowed dosage limit.
Effective 1 March 2017, once the accumulative dosage limit is exceeded; the cost for the additional quantity of the submitted product will be a surcharge to the member.
SamwuMed curator removed
A High Court judge has removed the provisional curator of medical scheme Samwumed, who he found was incurring “exorbitant” and “unproductive” expenses that were not helping to solve the scheme’s problems. Business Day reports that Judge AJ Engers found “good cause” to remove Duduza Khosana, who was earning R234,000 a month and has incurred expenses of at least R100,000 since her appointment at the 80,000-member Samwumed in May.
The judge said that Khosana was making “radical changes” at the scheme rather than serving her primary purpose, which was to fix the scheme’s dysfunctional board of trustees that resulted from faction fighting within the SA Municipal Workers Union (Samwu).
“I find it disturbing that she has seen fit to make what are possibly far-reaching decisions without having addressed the main problems she was supposed to,” Engers said in his judgment.
Bonitas claims price war victory over Life Healthcare
Bonitas, South Africa’s third largest medical scheme, is claiming victory in what it believes is the beginning of a competition and price war with private hospitals, notes Rapport.
The newspaper reported that Bonitas announced the exclusion of 14 large Life Healthcarehospitals for its 750,000 insured lives and warned they may do the same with other major groups.
Bonitas spends R360m annually at the 14 Life hospitals, and has imposed a 30% co-payment for members who continue to use these hospitals. Life Healthcare head of financers’ relations, Matthew Prior, says the group has waived the 30% so that Life patients who are members of Bonitas may continue to use their facilities without a financial burden.
The report says that according to acting chief officer Gerhard van Emmenis, this effectively means a 30% discount for Bonitas and a much better deal for the scheme. ‘I think every medical scheme is now standing at Life’s door asking why they cannot also get a 30% discount.’
He says the gap between the tariffs negotiated by the two largest schemes – Discoveryand GEMS – and what smaller schemes pay hospitals is getting wider. Bonitas plans to target the National Hospital Network (NHN) – a group of independent private hospitals – next.
NHN has an exemption from the Competition Commission to bargain as a collective with medical schemes, but Bonitas is planning to challenge this practice in court.
Web Based Medical Billing Software – Myth or Reality
Dispelling the fantasy
We are living in an increasingly digital world and the speed of technological change means that healthcare providers often struggle to keep. Moving to the cloud is a solution that offers distinctive benefits, but at the same time introducing additional risks.
Yes, the future is mobile. And increasingly medical and other healthcare practices are feeling inclined to follow the trend: the flexibility of being able to control their businesses from the palm of their hand.
Moving to the cloud comes with a fair amount of uncertainty. Concerns regarding malware, compliance and security are probably the first on the list but are not the only point of hesitation.
Lack of internet access, hardware failures, the fear of downtime, the loss of important data are all reasons why there is apprehension to cloud migration.
There are indeed those healthcare practices that have taken the leap and moved to the cloud, albeit settling for software with reduced feature set.
Yes, web based software in general, does not have the rich feature set that pedigreed desktop software such as Medinol has.
Web based medical billing software does sacrifice quite a lot compared to desktop software because it has to be downloaded from the web as it is needed.
Desktop medical billing software, on the other hand, resides on the local computer, which results in a lot faster and responsive user experience.
In a recent study 65% of business executives said that moving to the cloud has freed up IT resources to work on more strategic tasks and 64% added that these initiatives were implemented faster.
Despite increased efficiency, there are few myths being touted as to why moving your practice to the cloud is an option that should be considered as superior.
1. Does it really save you money
For practical purposes most cloud providers are located locally. They use the best hardware, software and skills. Data centres are also required to adhere to a variety of audits and industry standards. But because they are faceless, and often time their locale is not disclosed, can you really trust them to their commitment?
2. Does it provide access to world class infrastructure and skills
For practical purposes most cloud providers are located locally. They use the best hardware, software and skills. Data centres are also required to adhere to a variety of audits and industry standards. But because they are faceless, and often time their locale is not disclosed, can you really trust them to their commitment?
2. Does it provide access to world class infrastructure and skills
For practical purposes most cloud providers are located locally. They use the best hardware, software and skills. Data centres are also required to adhere to a variety of audits and industry standards. But because they are faceless, and often time their locale is not disclosed, can you really trust them to their commitment?
3. Up-to-date security and software
In the cloud, a specialist will take care of the security for you and every time you connect – you will hopefully have access to the latest version of applications. This is largely beyond your control, so you really need to be able to trust your cloud provider.
4. Data back-up – all taken care of
Hard drives packed with patient data lost to theft or fire is no longer a worry. A good cloud application will keep your data backed up to the last 24 hours without any need for special action from your side. Of course, you will still need to be concerned if your local computer equipment is at risk, but still, the reequirements are less onerous.
5. Productivity boost
Cloud provides a potential productivity increase of up to 400% says cloud providers as they tout their services. They seem to omit mentioning forget that there is still a cost involved in maintaining the connecting computer equipment.
So in summary, while there are distinct advantages in moviong your medical practice to the cloud, there are still very distinct advantages of running both the business and clinical sides of your practice on a local basis. The risks are still too big to migrate to web basedmedical billing software.