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Chronic Disease Abbreviations

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Abbreviations for CDL (Chronic Disease List) conditions:

ADS – Addison’s Disease

AST – Asthma

BCE – Bronchiectasis

BMD – Bipolar Mood Disorder

CHF – Cardiac Heart Failure

CMY – Cardiomyopathy

COP – Chronic Obstructive Pulmonary Disease

CRF – Chronic Renal Disease

CSD – Crohn’s Disease

DBI – Diabetes Insipidus

DM1 – Diabetes Mellitus Type 1

DM2 – Diabetes Mellitus Type 2

DYS – Dysrhythmias

EPL – Epilepsy

GLC – Glaucoma

HAE – Haemophilia

HYL – Hyperlipidaemia

HYP – Hypertension to view Formulary

IBD (UC) – Inflammatory Bowel Disease (Ulcerative Colitis)

IHD (CAD) – Ischaemic Heart Disease (Coronary Artery Disease)

MSS – Multiple Sclerosis

PAR – Parkinson’s disease

RHA – Rheumatoid Arthritis

SCZ – Schizophrenia

SLE – Systemic Lupus Erythematosus

TDH – Hypothyroidism

Brought to you be Medinol Medical Billing Practice Manegement Software

Clicks Discovery Flexicare

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Discovery Flexicare Health insurance

With Flexicare you can have access to affordable private healthcare cover and a world-class suite of digital tools to help you manage your membership and access your benefits on the go. Flexicare is a health insurance product, not a medical aid.

The benefit does not included hospital cover.

The benefits include:

  • Unlimited GP consults
  • Dentistry
  • X-rays
  • Maternity
  • Blood tests
  • HIV care
  • Medicine
  • Eye care
  • Flu vaccines
  • Health check
  • Procedures in GP rooms
  • Private ambulance

Kindly visit the following link for more information regarding Discovery Flexicare Health insurance, you can also sign up via the following link

https://clicks.co.za/clubcard/discovery-flexicare

GEMS Co-Payments: Some Clarity

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How are GEMS medicine co-payments calculated?

Here is the instruction given to GEMS patients:

Medicine co-payments with GEMS are calculated based on different scenarios:

1. Non-DSP Co-payment: If you get your medicine from a pharmacy other than the one you nominated, you will have to pay 30% of the price of the claim for the chronic medicine.

2. MPL Co-payment: This occurs when you choose a medicine priced higher than the GEMS maximum price for that medicine, for which there is a generic equivalent available. The co-payment is the difference between the price of the medicine you choose and the GEMS MPL price.

3. Out-of-Formulary Co-payment: This happens when the medicine you receive is not listed on the GEMS formulary specific to your option. This co-payment can apply either when your benefits have been exhausted for the year or throughout the year regardless of available benefits.

To avoid these co-payments, it’s important to get your medicine from the nominated pharmacy, choose medicines within the MPL price range, and ensure the prescribed medicine is on the formulary specific to your option.

 

by Medinol Best Medical Billing Software

Does Spectramed Medical Aid Still Exist?

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Does Spectramed Medical Aid Still Exist?

What Happened to Spectramed Medical Aid? A Look at Health Mergers in South Africa

For many South Africans, Spectramed Medical Aid was a familiar name in the healthcare landscape. But if you’re wondering if Spectramed still exists, the answer is a bit complex.

Merging for a Stronger Future (or So They Thought)

In 2018, Spectramed Medical Aid joined forces with Resolution Health Medical Scheme to form a new entity: Health Squared Medical Scheme. This merger aimed to create a more robust healthcare provider by combining resources and member bases.

Unfortunately, the Merger Didn’t Go as Planned

Despite initial optimism, Health Squared faced challenges. It struggled to retain younger members, leading to an imbalanced demographic. This, coupled with other financial difficulties, ultimately resulted in Health Squared’s liquidation.

What Does This Mean for Former Spectramed Members?

If you were previously a Spectramed member, you would have been transitioned to Health Squared during the merger. With Health Squared’s closure, you would have likely been advised to choose a new medical aid provider.

The Importance of Staying Informed as a Medical Aid Member

This situation highlights the importance of staying informed about changes within your medical aid scheme. Here are some tips:

  • Regularly review your medical aid provider’s communication. This could be emails, newsletters, or website updates.
  • Attend member meetings or webinars. These can provide valuable insights into the scheme’s health and future plans.
  • Don’t hesitate to contact your medical aid directly. Their customer service representatives can answer your questions and guide you through any transitions.

Choosing a New Medical Aid Provider

If you’re now looking for a new medical aid provider, here are some resources to help you make an informed decision:

  • The Council for Medical Schemes (CMS): The CMS is the industry regulator and offers a wealth of information on medical aid schemes in South Africa, including comparisons and guides https://www.medicalschemes.co.za/.
  • Independent medical aid comparison websites: These websites allow you to compare plans from different providers based on your needs and budget.

Medical Billing Made Easy: Streamline Your Healthcare Administration

While navigating medical aid changes can be complex, there are tools available to simplify healthcare administration. Medinol, a leading provider of medical billing software, can help streamline your medical aid claims process and ensure you receive the reimbursements you deserve.

Looking for a Reliable Medical Billing Partner?

Contact Medinol today and learn how our software can help you manage your healthcare finances effectively.

In Conclusion

Spectramed Medical Aid no longer operates independently. While the merger with Resolution Health aimed to create a stronger entity, it ultimately resulted in the closure of Health Squared. This situation underscores the importance of staying informed about your medical aid provider and being proactive in choosing a new plan if necessary.

By Medinol – Your Partner in Streamlined Medical Billing

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