Assisting Practitioners – New EDI Requirement
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Dental Practices
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Dear Trading Partners
Discovery Health Medical Scheme welcomes new members from WitsMed and Naspers Medical Fund
We are pleased to inform you that:
WitsMed will be amalgamating with Discovery Health Medical Scheme
Members on the N Option Plus and N Option Basic of the Naspers Medical Fund, will be joining Discovery Health Medical Scheme.
What the changes mean
Current WitsMed members, will be transferred to and become Discovery Health Medical Scheme members effective 1 January 2018, as per the rules of the amalgamation. All N Option Plus and N Option Basic members of the Naspers Medical Fund will be joining Discovery Health Medical Scheme, effective 1 January 2018.
Identifying the new Discovery Health Medical Scheme members
Discovery Health will issue new membership numbers and physical membership cards to former WitsMed and Naspers Medical Fund N Option members. Please note that members with smartphones will also be able to download and use digital membership cards, which are stored on their phones.
Submitting claims to Discovery Health
WitsMed claims with a service date up to 31 December 2017
Please submit all WitsMed member claims with a service date up to and including 31 December 2017 via email to claims@witsmed.co.za, using the member’s WitsMed membership number on the claim.
Or you can submit the claims electronically as you have been doing – using the member’s WitsMed membership number.
Providers will be given a grace period from 1 January 2018 to 30 April 2018 to submit 2017 claims, using the above mentioned email.
Claims submission for Naspers Medical Fund members on the N Option Plus and N Option Basic with a service date up to 31 December 2017
Please send all claims for members who were on the N Option Plus or N Option Basic of the Naspers Medical Fund with a service date up to and including 31 December 2017 via email to claims@discovery.co.za, using the member’s Naspers Medical Fund membership number on the claim.
Or you can submit the claims electronically as you have been doing – using the member’s Naspers Medical Scheme membership number.
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Providers will be given a grace period of 1 January 2018 to 30 April 2018 to submit 2017 claims, using the above mentioned email.
Claims with service date of 1 January 2018, onwards – for former members of both schemes
From 1 January 2018, please make sure you use the member’s new Discovery Health Medical Scheme membership number, which appears on the newly issued membership cards.
Submit electronic claims to Discovery Health using the Discovery CMS number – 1125
Alternatively, submit member claims via email to claims@discovery.co.za
Benefit confirmation and member validation
The provider will need to use the new members’ membership number for both schemes from January 2018 when doing either Member validation, Fund check or Virtual Quote on the Health Professional Zone.
We hope this information will make the transition as smooth as possible. Should you have any queries please email us at electronic@discovery.co.za
Regards
ETM Team
Specialised Claims
Discovery Health
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Department of Health has informed that the intended final implementation date has been postponed from 01 January 2014 to 01 June 2014.
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