Mandatory Changes To Claims Submitted Via MediSwitch
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Medical Billing Software: Web-Based or In-house?
When confronted with a choice between in-house based Medical Billing System and a web-based or hosted Medical Billing System system, which might happen to be the better choice for you and your practice?
Current economic hardship being what it is means more and more medical practitioners are finding themselves facing this critical question that needs a decision.
For starters, it is a good idea to have clarity on the understanding of both terms. In-house based Medical Billing systems where the application is based at the medical practitioner’s site, is the most popular. On the other hand a ASP or web-based Medical Billing system as the name suggests is hosted by a third party somewhere on the web.
Actually both systems have their pros and cons which a medical practitioner should closely examine in order to make an informed decision.
There is no question that you will always have much more control of things with a in-house based Medical Billing system. It is faster and you do not have to rely entirely on the Web to access your practice billing data. Suffice to say there is a price to pay and it starts with a generally higher upfront investment you will have to make to acquire the medical billing software outright. Moreover remote access to your Medical Billing System data when you are away from the practice is limited and generally a little complex than the case would be with a web based system.
On the other hand, a web based medical billing software means that your upfront costs reduce dramatically. Not only for the initial setup but also in terms of maintenance since the IT professionals belonging to the hosting vendor are obligated to maintain it and you should have no costs in that regard. Not to mention the online back-up service that is done automatically for you. And then you can always access your data from anywhere in the world as long as you have an Internet connection which has to be one of the greatest pluses a web based system has.
But in this greatest strength also lies its major weakness. And that is the fact that your access is totally dependant on an internet connection meaning that access in certain areas and under certain conditions will just not be possible.
Then there are the usual risks that go with web based medical billing systems. For instance your data could end up being completely inaccessible in the event that the online company hosting it goes belly up. Or your have cloud outages.
All these aspects have to be considered and deliberated upon before you make a decision. It will depend a lot on your practice, what you want to do with it and of course the medical billing software budget.
Universal Health to administer Old Mutual Staff Medical Aid Fund
Date: 26 June 2019
Dear Administrative Staff
Change of Administrator for Old Mutual Staff Medical Aid Fund (OMSMAF) with effect from 1 July 2019.
Mediswitch will seamlessly handle to routing of the claim to the new administratior, Universal Health
This serves to inform you that the current administration contract between OMSMAF and Medscheme has been terminated by mutual agreement. Universal Health has been appointed as the new administrator with effect from 1 July 2019.
In light of this, all OMSMAF claims with a service date subsequent to 30 June 2019 must be submitted directly to the new administrator. It is therefore important to ensure that the Scheme routing codes are updated accordingly in order for the claims to be correctly routed to the new administrator.
Please refer to the attached document for important information.
Kind regards,
Medscheme
Tags: Old+Mutual+Staff+Medical+Aid, OMSMAF, Universal+Health
Medical Schemes Administered by Universal Healthcare
2016 MEDSCHEME GP Tariffs
2016 Medscheme Administered Scheme Tariffs
1. Tariff increases for 2016:
After due consideration by each individual medical schemes’ board of trustees, the following tariff increases will apply to the scheme tariffs of the Medscheme-administered schemes listed below with effect from 1 January 2016:
| Scheme | % Increase | Scheme | % Increase |
| AECI Medical Aid Society | 6.00% | MBMed Medical Aid Fund | 5.30% |
| Barloworld Medical Aid | 5.30% | Nedgroup Medical Aid Scheme | 6.10% |
| Bonitas Medical Fund | 5.20% | Old Mutual Staff Medical Aid Fund | 6.00% |
| Fedhealth | 5.50% | Parmed Medical Aid Scheme | 5.30% |
| Glencore Medical Scheme | 5.50% | SABC Medical Scheme | 5.30% |
| Horizon Medical Scheme | 6.00% | Sasolmed Medical Aid Scheme | 5.20% |
Note: Scheme tariffs are VAT inclusive. The above tariff increases will be made available on the Medscheme website. Go to www.medscheme.com and click on Look Up Tool > Scheme Rates > 2016.
2. Scheme changes for 2016:
Fedhealth
The Maxima Standard Net option will be discontinued as of 31 December 2015 and a new option introduced, namely the Maxima Standard Elect as of 1 January 2016.
Bonitas
Bonitas have introduced 2 new options namely the Standard Select and the BonFit option as of 1 January 2016.
3. New Schemes administered by Medscheme:
POLMED
With effect from 1 January 2016, Polmed Medical Aid Scheme will be administered by Medscheme.
Should you have any queries with regards to the information provided in this letter, please call the Healthcare Professional Contact Centre on 0861 112 666.
New Scheme Info: RAND MUTUAL
1. NEW SCHEME INFORMATION
With immediate effect, acute and chronic dispensing claims for Rand Mutual members can now be submitted via MediKredit, for processing and payment on the existing option indicated in the summary table below.
2. DISPENSING FEE
a) Schedule 0, 98 and 99 items calculated on the published wholesale price: 36%
b) Schedule 1 to 7 calculated on Single Exit Price:
AMOUNT RANGE (Incl. VAT)
R0 – R90.00 =====>>>>>> 34.20%
MARK-UP/DISPENSING FEE (Incl. VAT)
R90.01 – R99999999.99 =====>>>>>> R30.78
SUMMARY OF OPTIONS
CLAIMS TYPE ACUTE DISPENSING
SUBMITTING OPTION NAME RAND MUTUAL PHCY AND DISP DR
OPTION CODE RANDJ 646906