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Medical Aid

Medical Aid

SCHEMES ADMINISTERED BY METROPOLITAN HEALTH GROUP

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SCHEMES ADMINISTERED BY METROPOLITAN HEALTH GROUP

Date: 28 November 2014

SCHEMES ADMINISTERED BY METROPOLITAN HEALTH GROUP

SCHEME CLIENT SERVICE NUMBER EMAIL ADDRESS

Bankmed 0800 226 5633 enquiries@bankmed.co.za

BP 08000 001 607 bpmas@mhg.co.za

Engen 08000 001 615 engen@mhg.co.za

Fishmed 0860 104 121 fishingindustry@mhg.co.za

Golden Arrow 0860 104 122 goldenarrow@mhg.co.za

ImperialMed 0860 467 374 imperialmedenquiries@mhg.co.za

Medipos 0860 100 078 mediposenquiries@mhg.co.za

Metropolitan 0861 888 104 metromed@mhg.co.za

PG Group 0860 005 037 info@pggmeds.co.za

Pick n Pay 0800 004 389 picknpay@mhg.co.za

Polmed 0860 765 633 polmed@mgh.co.za

Transmed Working & Pension

Members  0800 450 010 enquiries@transmed.co.za

Transmed SATS Pension

Members  0800 110 268 enquiries@transmed.co.za

Wooltru 0802 228 922 wooltru@mhg.co.za

GEMS 0860 00 4367 enquiries@gems.gov.za

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

Xstrata Name Change to Glencore 2014-01-01

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On 1 January 2014, the Xstrata Alloys Medical Aid Scheme name will change to Glencore Medical Scheme, and all our members will receive a new membership card (as shown on the right) with their existing membership number during the first quarter of 2014.

The Scheme has also removed the 20% co-payment from certain benefits and introduced monetary limits for acute medicines, out-of-hospital pathology and additional medical services in hospital. Set out below are some of the Scheme’s benefit limits for 2014 including the new monetary limits: Benefit

Monetary limits

Acute medicines

Member: R4,000

Member +1 dependant: R7,000

Member +2 dependants: R9,000

Member +3 or more dependants: R10,000

Medicine on discharge from hospital (TTOs) subject to the Acute medicine limit

R392 per beneficiary per admission

Over the counter medicine subject to the Acute medicine limit

R 1,300 per family with a maximum of R323 per script

GP and Specialist consultations out-of-hospital

Member: R4,000

Member +1 dependant: R6,000

Member +2 dependants: R8,000

Member + 3 or more dependants: R10,000

Related maternity services

R6,466 per family

Additional medical services

In-hospital: R10,000 per family

Out-of-hospital: R3,578 per family

Rehab for substance abuse

Included in the Mental Health limit

Pathology

In hospital: Subject to the overall annual limit

Out-of-hospital: R7,200

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TFG Medical Aid Scheme administered by Discovery Health

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TFG Medical Aid Scheme to be administered by Discovery Health (Pty) Ltd from 1 January 2012

 

Discovery Health (Pty) Ltd administers 13 medical schemes at the moment. We’re pleased to let you know that from 1 January 2012, Discovery Health will also be administering TFG Medical Aid Scheme.

 

To ensure that healthcare providers and members of TFG Medical Aid Scheme experience a seamless transition in claiming under the new administrator, we include information about where you need to send claims for the members of TFG Medical Aid Scheme from 1 January 2012.

 

To identify themselves as valid members, members will carry membership cards issued by Discovery Health, branded with TFG Medical Aid Scheme logo. This is a typical example:

 

 

 

 

 

 

 

 

 

 

 


Submitting claims to TFG Medical Aid Scheme

 

Claims with a service date up to 31 December 2011

 

You can send claims with a service date up to 31 December to Metropolitan Health Group (MHG) as you have always done. You will have four months to send claims with a service date until the end of December 2011 to the Scheme. Any claims received after this will not be paid.

 

Claims with a service date from 1 January 2012

 

Please send claims for members of TFG Medical Aid Scheme to Discovery Health from 1 January 2012. You will need to use the member’s new membership number, which is printed on the newly issued membership cards.

 

 

Planned hospital admissions

 

Discovery Health will transfer all approved hospital admissions of members for 2012 to its administration database.

 

 

Reimbursement of claims for members of TFG Medical Aid Scheme

 

The Scheme will reimburse all GP’s in the GP network at the network rate, although TFGMAS benefits will apply.  TFGMAS has also adopted the Premier Rate Payment Arrangement for 2012.  TFG Medical Aid Scheme has also adopted the Discovery Health Rate as their rate of reimbursement of all claims with certain exceptions which will continue to be covered at the specific TFGMAS tariff.

Medical Aid Telephone Numbers

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MEDICAL AID CONTACT TELEPHONE NUMBERS

Courtesy of Medinol Practice Management Software

 

 

Medical Aid Name Telephone Number
 
AFRISAM SA MEDICAL SCHEME 011-767-7242
AFROX MEDICAL AID SOCIETY 0800-003-749
ALLCARE 011-290-6200
ALLIANCE MIDMED MED SCHEME 086-000-2101
ALTRON MEDICAL AID SCHEME 011-290-6200
ANGLOAMERICAN 0860-222-633
ANGLOVAAL 0860-100-456
AUTOMED 021-948-6400
BANKMED 0800-226-5633
BARLOWORLD MEDICAL SCHEME 086-111-2666
BENMED 011-293-1600
BESTMED MEDICAL SCHEME 086-000-2378
BMW EMPLOYEES MEDICAL AID SOCIETY 086-000-2107
BONITAS MEDICAL FUND 0860-002-147
BP MEDICAL AID SOCIETY 021-480-4610
BUILDING & CONSTRUCTION INDUSTRY MEDICAL FUND 011-208-1000
BUILDINGMED 021-950-7400
BUILT ENVIRONMENT PROFESSIONAL ASSOC (BEPMED) 031-5734000
CAPE MEDICAL PLAN 086-010-2930
CARECROSS 0860-101-159
CARLTON PAPER 021-423-2609
CHARTERED ACCOUNTANTS MEDICAL AID FUND (CAMAF) 086-170-0600
CLICKS GROUP MEDICAL SCHEME 021-4601202
COMMED 086-131-1911
COMMUNITY MEDICAL AID SCHEME (COMMED) 011-290-6338
COMPCARE WELLNESS MEDICAL SCHEME 011-2081000
DE BEERS BENEFIT SOCIETY 053-807-3111
DENIS 860033647
DISCOVERY HEALTH MEDICAL SCHEME 0860-445-566
DRC 086-111-5057
EDCON MEDICAL AID SCHEME 011-495-6707
ENGEN MEDICAL BENEFIT FUND 080-000-1615
EYETHUMED MEDICAL SCHEME 0860-502-502
FEDHEALTH MEDICAL SCHEME 0860-104-555
FISHING INDUSTRY MEDICAL SCHEME (FISH-MED) 086-010-4121
FOOD WORKERS MEDICAL BENEFIT FUND 021-9303550
FOSCHINI GROUP MEDICAL AID SCHEME 021-480-5064
GEMS 086-000-4367
GEN-HEALTH MEDICAL SCHEME 011-457-8700
GENESIS MEDICAL SCHEME 0860-102-010
GOLD FIELDS MEDICAL SCHEME 041-395-4400
GOLDEN ARROWS EMPLOYEES MEDICAL BENEFIT FUND 0860-104-122
GOOD HOPE MEDICAL AID SOCIETY 011-208-1000
GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS) 012-362-6321
GRINTEK ELECTRONICS MEDICAL AID SCHEME 011-208-1000
HOSMED MEDICAL AID SCHEME 0860-000-048
IBM (SA) MEDICAL SCHEME 086-010-0418
IMPALA MEDICAL PLAN 014-5697597
IMPERIAL GROUP MEDICAL SCHEME 086-046-7374
INGWE HEALTH PLAN 086-010-2493
KEYHEALTH 086-067-1050
KILOCARE 021-931-7356
LA-HEALTH MEDICAL SCHEME 021-555-4727
LAMAF 021-402-8840
LIBCARE MEDICAL SCHEME 080-012-2273
LIBERTY MEDICAL SCHEME 086-000-2163
LONMIN MEDICAL SCHEME 086-010-4883
MALCOR MEDICAL SCHEME 011-372-1500
MASSMART HEALTH PLAN 086-000-2117
MBMED MEDICAL AID FUND 011-510-2000
MEDCOR 012-673-8733
MEDICOVER 086-000-2163
MEDIHELP 086-010-0678
MEDIMED MEDICAL SCHEME 041-395-4400
MEDIPOS MEDICAL SCHEME 086-010-0078
MEDSHIELD MEDICAL SCHEME 0860-002-147
MEDSCHEME 086-111-2666
METHEALTH 021-480-4411
METROCARE 086-000-2123
METROPOLITAN MEDICAL SCHEME 086-188-8104
MIMED 011-329-8800
MINEMED MEDICAL SCHEME 041-395-4400
MOMENTUM HEALTH 086-011-7859
MOREMED MEDICAL SCHEME 086-010-1103
MOTO HEALTH CARE 086-132-9800 / 0861 000 300
MUNIMED 0860-671-1050
MX HEALTH 012-673-8985
NAMPAK (SA) MEDICAL SCHEME 086-010-1047
NASPERS MEDICAL FUND 0860-445-5666
NATIONAL INDEPENDENT MEDICAL AID SOCIETY (NIMAS) 0860-100-670
NBC MED 011-290-6200
NEDGROUP MEDICAL AID SCHEME 086-111-2666
NETCARE MEDICAL SCHEME 086-010-3406
NIMAS 0860-100-671
NMP (NATIONAL) 031-573-4000
OLD MUTUAL STAFF MEDICAL AID FUND 0860-100-456
OMNI-HEALTH 0860-888-014
OPMED 012-427-5333
ONE CARE 011-234-3578
OXYGEN MEDICAL SCHEME 021-532-6800 or 0860 101 233
PARMED MEDICAL AID SCHEME 086-000-2126
PG BISON MEDICAL AID SOCIETY 086-010-9595
PG GROUP MEDICAL SCHEME 11-417-5800
PHAROS MEDICAL PLAN 031-267-5000
PICK N PAY MEDICAL SCHEME 080-000-4389
POLMED 086-076-5633
PLATINUM HEALTH 014-591-3069
PRIMECURE 086-166-5665
PROFMED 086-067-9200
PROSANO MEDICAL SCHEME 0860-002-035
PROFMED 011-628-8904
PROTEA MEDICAL AID SOCIETY 021-552-7111
PROTECTOR 012-421-2022
PROVIA 0860-102-472
PROVIDENCE 041-395-4545
PUREHEALTH MEDICAL SCHEME 086-010-9393
QUANTUM MEDICAL AID SOCIETY 086-010-2958
RAND WATER MEDICAL SCHEME 011-682-0560
REMEDI MEDICAL AID SCHEME 0860-102-472
RESOLUTION HEALTH MEDICAL SCHEME 0861-111-778
RETAIL MEDICAL SCHEME 021-980-4465
RHODES UNIVERSITY MEDICAL SCHEME 041-395-4476
S A BREWERIES MEDICAL AID SOCIETY 086-000-2133
SABC MEDICAL AID SCHEME 086-000-2136
SAMWUMED 086-010-4117
SAPPI MEDICAL AID SCHEME 086-010-1280
SASOLMED 086-000-2134
SEDMED 051-4478271
SELFMED MEDICAL SCHEME 086-010-5508
SIEMENS MEDICAL SCHEME 011-671-2000
SIZWE MEDICAL FUND 0860-100-871
S.A. POLICE SERVICE MEDICAL SCHEME (POLMED) 012-431-0239
SOVEREIGN HEALTH 031-367-6800
SPECTRAMED 0861-497-497
STATUS – UNIVERSAL 011-208-1000
STOCKSMED 086-000-2137
SUREMED HEALTH 086-008-0888
TELEMED 0860-119-553
THEBEMED 011-5448899
TIGER BRANDS MEDICAL SCHEME 011-2081000
TOPMED MEDICAL SCHEME 0860-002-158
TRANSMED MEDICAL FUND 080-011-0268
TRAWLMED 021-712-8775
TSOGO SUN GROUP MEDICAL SCHEME 086-010-0421
UMED 012-667-8008
UMVUZO HEALTH MEDICAL SCHEME 012-8450000
UNIVERSITY OF KWAZULU NATAL MEDICAL SCHEME 031-260-1007
UNIVERSITY OF WITWATERSRAND STAFF MEDICAL AID 086000-2140
WITBANK COALFIELDS MEDICAL AID SCHEME 013-6561407
WOOLTRU HEALTHCARE FUND 080-222-8922
XPRESS CARE 011-375-3000
XSTRATA MEDICAL AID SCHEME 086-000-2141

 

 

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