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Macaine 0.5% QTY CHANGE

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This email is to notify you of a change we have made to the product MACAINE 0.5% 10ML INJ billing quantity. The NAPPI code for the products is 740292005.
This product has always been listed as PER ML pricing but it seems the schemes have changed their payment structure around this product. The product is registered with Medikredit as 10 x 10ml vials.
As from Friday 7 August 2020, the product will be listed as qty 10 and you will only be able to bill per full vial. We have had confirmation that the vial cannot be re-used and should the entire vial not be used then it needs to be discarded. An entry of 1 in the qty will therefore charge you for ONE entire vial opposed to previously only billing ONE Millilitre.
For our medicine price file, see http://medicinepricefile.co.za

 

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Discovery Health Subscription Increase 2018

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Discovery Health Subscription Increase 2018

Date: 20 Sep 2017

With a flurry of new NHI regulations breaking ground in 2017, medical aid schemes in South Africa are under pressure with an uncertain future. However, one thing is always guaranteed – price increases.

Discovery Health has announced that customers can expect a rather large increase to contributions in 2018, with the weighted average coming in at 7.9% across its plans.

  • Executive and Smart plan options will be increasing at an average of 7.3%
  • Core and Saver plan options will increase at an average of 7.6%
  • Priority and KeyCare plan options will increase at an average of 8.3%

This increase is not as large as the jump seen in 2017 (where the average was 10.2%), but remains high above inflation, which is around 6% this year. However, Discovery maintains that the increase is below medical aid inflation – the indicator it uses to decided its price increases for medical aid schemes – which is estimated to be at 9% this year.

“Over the 12-month period of August 2016 to July 2017, average CPI was 5.93%. Using CPI + 3% as an indication of medical inflation, the average medical inflation over this period was 8.93%. Thus, the DHMS average increase of 7.9% is well within the medical inflation corridor of CPI+3%,” Discovery said.

The group said that its rates are currently 15.1% lower than its competitors, and it expects that this gap will widen in 2018.

Along with the price increases, Discovery Health clients can also expect enhanced offerings, it said, with improved maternity and child benefits, and extended international health coverage for members on the Executive scheme.

Other new benefits include over-the-counter cover for Schedule 0-2 medicines on the Smart plan, and increased limits on all benefits (in line with each individual plan-specific contribution increase).

The group will also introduce a new technology platform called DrConnect, which will allow members to connect directly with a network of health professionals from smart devices. The platform uses AI to connect 105,000 doctors with millions of patients around the world to answer health questions.

—->>> Read more

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MEDINOL MEDICAL BILLING | PRACTICE MANAGEMENT SOFTWARE

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, controls your outstanding debtors, 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 https://medinol.co.za.

Contact:

Fudley Bezuidenhout Pr.Eng.
Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

GEMS REO GP Network 2013 Dispensing Fees

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Dear Healthcare Professional,

As a dispensing GEMS Network doctor please apply the following dispensing
fee calculation for medicine which you dispense to the GEMS REO members:

Single Exit Price (SEP) incl VAT Maximum Dispensing Fee (MDF) excl VAT
<R90 30% of SEP
>R90 R27

Note:
1. As a participating GEMS REO GP Network doctor you agree not to charge our
members co-payments over and above the above maximum dispensing fee.
2. For a copy of the 2013 formulary go to the GEMS website (www.gems.gov.za)
and click Healthcare Providers > ICD-10 Code/Formulary Check Service > 2013 REO
Comprehensive Formulary.

Should you have any further queries, please contact GEMS

Call Centre: 0860 00 4367 (GEMS)
Website: www.gems.gov.za
Email: enquiries@gems.gov.za

Yours sincerely,

GEMS Managed Care

 

To implement in Medinol Medical Aid Billing Software:

  1. Go into Medinol
  2. Select Process -> Command Prompt
  3. At the Command Prompt, enter SYSMAINT
  4. Adjust entries at the bottom of the first screen (note: use VAT INCLUSIVE FIGURES)
  5. Press Enter to get pass all the other screens.
  6. Enter EXIT once you are back at the command prompt
  7. Escape out of Medinol back to Windows, then re-enter Medinol for settings to take effect.

 

Problems? Email us on info@medinol.co.za

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NHI: Medical schemes to continue..

SA Government said that it expected the National Health Insurance (NHI) to be fully functional in South Africa by 2026.

On Thursday, Health Minister Zweli Mkhize released the much-awaited bill in Pretoria and it was widely welcomed by various groups in the sector.

The Health Department said the bill promised to create a healthier population with benefits to foreign nationals, inmates and refugees.

Deputy Director-General Anban Pillay: “The NHI is intended to be implemented over a 7-year period from now. It’s planned to be fully implemented by 2026 through a phased implementation approach and the bill identifies the two phases – we are now in phase two – and then there’s a phase three thereafter. Phase two ends in 2022, phase three commences in 2023 to 2026.”

Health minister Zweli Mkhize has thrown the medical schemes industry a lifeline, with provisions in the latest iteration of the National Health Insurance (NHI) Bill that enable them to continue until the ambitious scheme for universal health coverage is fully implemented.

At that stage, they will be restricted to offering cover for “complementary” services not covered by NHI.

The development will offer welcome reassurance to medical schemes, their administrators and brokers, which feared they might be legislated out of existence in one fell swoop. The transition is also likely to give comfort to consumers who currently use medical schemes to pre-fund their access to private healthcare services.

Medical Billing Software to contnue unchanged until at least 2026.

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Positive Effect of Single Exit Price (SEP)

State control cut medicine costs significantly, study shows

Single-exit price regulations aimed at easier access to private-sector medication and transparency in supply chain.

The government’s controversial controls on private-sector medicine prices delivered immediate and sustained savings after they were implemented in 2004, according to research published earlier this week in peer-review journal PLOS ONE.

The study found there was a significant drop in prices of innovator drugs and generic copies of those that were no longer patent protected.

The health department introduced the single-exit price (SEP) regulations in an attempt to make private-sector medicines more accessible by regulating prices and introducing transparency along the entire supply chain, from manufacturer gate to pharmacy shelf. The SEP is the ex-manufacturer price of a medicine combined with the logistics fee and VAT, and is the same for all customers, regardless of volume bought. The regulations also cap dispensing fees pharmacists and dispensing doctors may levy.

When the SEP regulations came into effect, a new price was calculated for each private-sector medicine, based on the weighted average of all of the previous year’s sales, including all the discounts and off-invoice rebates enjoyed by key customers. Since then, manufacturers usually get only one price increase a year at a ceiling set by the pricing committee that advises the health minister.

Until now there has been little hard evidence of the effect of this policy. But in a study published in PLOS ONE this week, researchers showed that there were significant and immediate price cuts for the majority of medicines, and that in many cases prices continued to fall.

“This research shows the SEP had a real impact, even on generic pricing, which came down remarkably,” said study co-author Fatima Suleman, who is professor of pharmaceutical sciences at the University of KwaZulu-Natal.

The researchers selected three baskets of drugs, and examined prices between 1999 and 2014. In one of the baskets, dubbed the “global” core and drawn from a list of World Health Organisation-approved medicines, they found 10 out of 14 originator molecules showed a significant price drop in 2014. Twenty six out of 28 generics also saw a sharp price cut, and two-thirds of the medicines (65%) saw a sustained drop in prices.

The SEP regulations were immensely controversial when they were first flighted. Pharmaceutical manufacturers warned that the government’s plans to cut medicine prices threatened their viability. Retail pharmacists launched a legal challenge that went all the way to the Constitutional Court, but ultimately saw their dispensing fees regulated.

 

Original article

 

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