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Medical Practices

Medical Practices

Rand Mutual information session

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Rand Mutual claims submission and processes information sessions:

Rand Mutual Assurance (RMA) invites all medical service providers to the following information

sessions where important need-to-know information regarding RMA’s processes and claim

submissions, as well as introduction to RMA’s user-friendly medical portal will be discussed.

These sessions are intended for all Medical Service Providers, Healthcare Professionals and

facilities.

RSVP: Carika Pretorius

cpretorius@randmutual.co.za 010-214-3081

POTCHEFSTROOM,

11 May 2015, 18:00 – 20:00, North West university, 11 Hoffman Street, Potchefstroom

DURBAN (UMHLANGA),

14 May 2015, 18:00 – 20:00, Gateway Private Hospital, Training Room, 6

th

floor, 36 Aurora Drive, Umhlanga

EAST LONDON,

18 May 2015, 18:00 – 20:00, Premier Hotel, 22 Esplanade Street, East London

PORT ELIZABETH,

19 May 2015, 18:00 – 20:00, Protea Hotel Marine, Marine Drive, Port Elizabeth

VAAL TRIANGLE,

20 May 2015, 18:00 – 20:00, Quest North-West University, Curie Boulevard, Vanderbijlpark

PRETORIA,

25 May 2015, 18:00 – 20:00, Premier Hotel, 573 Kerk Street, Pretoria

JOHANNESBURG,

25 May 2015, 18:00 – 20:00, Sunnyside Park Hotel, Princess of Wales Terrace, Parktown

BLOEMFONTEIN,

28 May 2015, 18:00 – 20:00, Horizon Eye Care Centre (Bloemfontein Eye), 54 Pasteur Drive,

Hospital Park, Bloemfontein

Tags:

Dispensing Doctors

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Graphic -- Breaking News icon

Dispensing Fees on SEP increased.

According to Government Gazette 33906 dated 24/12/2010:

SEP on Medicine Items <= R88.92  Disp Fee: 30.0%

SEP on Medicine Items > R88.92   Disp Fee: R26.67 (capped)

* Inclusive of VAT

** Applies from 1 Jan 2011

Please update your software accordingly.

DELETED ICD-10 codes GPs 2013-06

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ICD10_3_Code ICD10_3_Code_Desc ICD10_Code WHO_Full_Desc Status Comment
H54 Visual impairment including blindness (binocular or monocular) H54.7 Unspecified visual loss D Discontinue code
I84 Haemorrhoids I84 Haemorrhoids D Discontinue code
I84 Haemorrhoids I84.0 Internal thrombosed haemorrhoids D Discontinue code
I84 Haemorrhoids I84.1 Internal haemorrhoids with other complications D Discontinue code
I84 Haemorrhoids I84.2 Internal haemorrhoids without complication D Discontinue code
I84 Haemorrhoids I84.3 External thrombosed haemorrhoids D Discontinue code
I84 Haemorrhoids I84.4 External haemorrhoids with other complications D Discontinue code
I84 Haemorrhoids I84.5 External haemorrhoids without complication D Discontinue code
I84 Haemorrhoids I84.6 Residual haemorrhoidal skin tags D Discontinue code
I84 Haemorrhoids I84.7 Unspecified thrombosed haemorrhoids D Discontinue code
I84 Haemorrhoids I84.8 Unspecified haemorrhoids with other complications D Discontinue code
I84 Haemorrhoids I84.9 Unspecified haemorrhoids without complication D Discontinue code
K35 Acute appendicitis K35.0 Acute appendicitis with generalized peritonitis D Discontinue code
K35 Acute appendicitis K35.1 Acute appendicitis with peritoneal abscess D Discontinue code
K35 Acute appendicitis K35.9 Acute appendicitis, unspecified D Discontinue code
K51 Ulcerative colitis K51.1 Ulcerative (chronic) ileocolitis D Discontinue code
N18 Chronic kidney disease N18.0 End-stage renal disease D Discontinue code
N18 Chronic kidney disease N18.8 Other chronic renal failure D Discontinue code
R50 Fever of other and unknown origin R50.00 Fever with chills D Code discontinued and ended on the 31/08/2007
R50 Fever of other and unknown origin R50.10 Persistent fever D Code discontinued and ended on the 31/08/2007
X59 Exposure to unspecified factor X59.1 Exposure to unspecified factor, residential institution D Discontinue code
X59 Exposure to unspecified factor X59.10 Exposure to unspecified factor, residential institution, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.11 Exposure to unspecified factor, residential institution, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.12 Exposure to unspecified factor, residential institution, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.13 Exposure to unspecified factor, residential institution, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.14 Exposure to unspecified factor, residential institution, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.18 Exposure to unspecified factor, residential institution, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.19 Exposure to unspecified factor, residential institution, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.2 Exposure to unspecified factor, school, other institution and public administrative area D Discontinue code
X59 Exposure to unspecified factor X59.20 Exposure to unspecified factor, school, other institution and public administrative area, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.21 Exposure to unspecified factor, school, other institution and public administrative area, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.22 Exposure to unspecified factor, school, other institution and public administrative area, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.23 Exposure to unspecified factor, school, other institution and public administrative area, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.24 Exposure to unspecified factor, school, other institution and public administrative area, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.28 Exposure to unspecified factor, school, other institution and public administrative area, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.29 Exposure to unspecified factor, school, other institution and public administrative area, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.3 Exposure to unspecified factor, sports and athletics area D Discontinue code
X59 Exposure to unspecified factor X59.30 Exposure to unspecified factor, sports and athletics area, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.31 Exposure to unspecified factor, sports and athletics area, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.32 Exposure to unspecified factor, sports and athletics area, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.33 Exposure to unspecified factor, sports and athletics area, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.34 Exposure to unspecified factor, sports and athletics area, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.38 Exposure to unspecified factor, sports and athletics area, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.39 Exposure to unspecified factor, sports and athletics area, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.4 Exposure to unspecified factor, street and highway D Discontinue code
X59 Exposure to unspecified factor X59.40 Exposure to unspecified factor, street and highway, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.41 Exposure to unspecified factor, street and highway, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.42 Exposure to unspecified factor, street and highway, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.43 Exposure to unspecified factor, street and highway, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.44 Exposure to unspecified factor, street and highway, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.48 Exposure to unspecified factor, street and highway, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.49 Exposure to unspecified factor, street and highway, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.5 Exposure to unspecified factor, trade and service area D Discontinue code
X59 Exposure to unspecified factor X59.50 Exposure to unspecified factor, trade and service area, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.51 Exposure to unspecified factor, trade and service area, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.52 Exposure to unspecified factor, trade and service area, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.53 Exposure to unspecified factor, trade and service area, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.54 Exposure to unspecified factor, trade and service area, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.58 Exposure to unspecified factor, trade and service area, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.59 Exposure to unspecified factor, trade and service area, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.6 Exposure to unspecified factor, industrial and construction area D Discontinue code
X59 Exposure to unspecified factor X59.60 Exposure to unspecified factor, industrial and construction area, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.61 Exposure to unspecified factor, industrial and construction area, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.62 Exposure to unspecified factor, industrial and construction area, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.63 Exposure to unspecified factor, industrial and construction area, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.64 Exposure to unspecified factor, industrial and construction area, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.68 Exposure to unspecified factor, industrial and construction area, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.69 Exposure to unspecified factor, industrial and construction area, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.7 Exposure to unspecified factor, farm D Discontinue code
X59 Exposure to unspecified factor X59.70 Exposure to unspecified factor, farm, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.71 Exposure to unspecified factor, farm, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.72 Exposure to unspecified factor, farm, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.73 Exposure to unspecified factor, farm, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.74 Exposure to unspecified factor, farm, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.78 Exposure to unspecified factor, farm, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.79 Exposure to unspecified factor, farm, during unspecified activity D Discontinue code
X59 Exposure to unspecified factor X59.8 Exposure to unspecified factor, other specified places D Discontinue code
X59 Exposure to unspecified factor X59.80 Exposure to unspecified factor, other specified places, while engaged in sports activity D Discontinue code
X59 Exposure to unspecified factor X59.81 Exposure to unspecified factor, other specified places, while engaged in leisure activity D Discontinue code
X59 Exposure to unspecified factor X59.82 Exposure to unspecified factor, other specified places, while working for income D Discontinue code
X59 Exposure to unspecified factor X59.83 Exposure to unspecified factor, other specified places, while engaged in other types of work D Discontinue code
X59 Exposure to unspecified factor X59.84 Exposure to unspecified factor, other specified places, while resting, sleeping, eating or engaging in other vital activities D Discontinue code
X59 Exposure to unspecified factor X59.88 Exposure to unspecified factor, other specified places, while engaged in other specified activities D Discontinue code
X59 Exposure to unspecified factor X59.89 Exposure to unspecified factor, other specified places, during unspecified activity D Discontinue code
Tags: ,

2011 Discovery Tariffs GP

2

Discovery Health

“For 2011, we will be increasing the base Discovery Health Rate by 4.9% and the consultation rate for GPs participating in the Discovery Health GP Network by 5.6% to R285 (the consultation rate for GPs not participating in the GP Network will increase to R264).”

GP Meds Markup and Dispensing Fee

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Please Note: There is a serious problem with the dispensing fee promulgated by GEMS for Government Employees.Contact us for details.

 

 

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SPECIAL NOTE: # – Changes since last list and highlighted in Bold
EFFECTIVE JUNE 2012
SCHEME / PLAN/ OPTIONS ADMINISTRATOR FAMCHECK MARK-UP/DISPENSING FEE % (Incl. VAT) MMAP, REF or URP
SEP PRODUCTS NON-SEP PRODUCTS
A AECI DD MedScheme
AECI P&C MedScheme
AFROX BASE ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 35 N
AFROX BASE CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 35 N
AFROX P&C MHG F
ALLIANCE MIDMED DD Momentum F
ALLIANCE MIDMED P&C Momentum F
ALTRON DD Discovery F
ALTRON P&C Discovery F
ANGLO MEDICAL MANAGED CARE ACUTE Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% – Max R18.24 N
ANGLO MEDICAL MANAGED CARE CHRONIC Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% – Max R18.24 Y
ANGLO MEDICAL MANAGED CARE GP & SPECIALIST Momentum F
ANGLO MEDICAL STANDARD ACUTE Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% – Max R18.24 Y
ANGLO MEDICAL STANDARD CHRONIC Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% – Max R18.24 Y
ANGLO MEDICAL STANDARD GP & SPECALIST Momentum F
ANGLO VALUE CARE GP P&C Prime Cure
ANGLO VALUE CARE SPECIALIST P&C Prime Cure
ANGLOVAAL DD Discovery F
ANGLOVAAL P&C Discovery F
B BANKMED BASIC ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
BANKMED BASIC CHRONIC (PMB ONLY) MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED COMPREHENSIVE ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
BANKMED COMPREHENSIVE CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED COMPREHENSIVE GP & SPECIALIST MHG F
BANKMED CORE SAVER ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
BANKMED CORE SAVER CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED CORE SAVER GP & SPECIALIST MHG F
BANKMED NAMIBIA GP & SPECIALIST MHG F
BANKMED PLUS ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED PLUS CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED PLUS GP & SPECIALIST MHG F
BANKMED TRADITIONAL ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED TRADITIONAL CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
BANKMED TRADITIONAL GP & SPECIALIST MHG F
BARLOWORLD DD MedScheme
BARLOWORLD P&C MedScheme
BCIMA (Building & Construction Industry) Universal Health F
BCIMA (Building & Construction Industry) Universal Health F
BESTMED PULSE 1 GP P&C Prime Cure F
BESTMED PULSE 1 SPECIALIST P&C Prime Cure F
BESTMED DD Bestmed
BESTMED P&C Bestmed
BIMAF (BUILDING INDUSTRY) Building Industries F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
BIMAF GP & SPECIALIST Building Industries F
BMW DD MedScheme
BMW P&C MedScheme
BONITAS BONCAP GP P&C Prime Cure F
BONITAS BONCAP SPECIALIST P&C Prime Cure F
BONITAS DD MedScheme
BONITAS P&C MedScheme
BP DD MHG
BP P&C MHG
C CAMAF ALLIANCE ACUTE Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
CAMAF ALLIANCE CHRONIC Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAMAF DOUBLE PLUS ACUTE Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 N
CAMAF DOUBLE PLUS CHRONIC Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAMAF ESSENTIAL CHRONIC Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAMAF FIRST CHOICE ACUTE Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAMAF FIRST CHOICE PMB Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAMAF VITAL CHRONIC Eternity F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
CAPE MEDICAL PLAN DD Cape Medical Plan
CAPE MEDICAL PLAN P&C Cape Medical Plan
COMPCARE DD Universal Health F
COMPCARE P&C Universal Health F
D DE BEERS DD De Beers F
DE BEERS P&C De Beers F
DISCOVERY DD Discovery F
DISCOVERY P&C Discovery F
DISCOVERY KEYCARE DD Discovery F
DISCOVERY KEYCARE P&C Discovery F
E ELLERINE HOLDINGS DD MedScheme
ELLERINE HOLDINGS P&C MedScheme
ENGEN DD MHG F
ENGEN P&C MHG F
EYETHUMED DD MedScheme
EYETHUMED P&C MedScheme
EYETHUMED PRIME CURE GP P&C Prime Cure
F FEDHEALTH DD MedScheme
FEDHEALTH P&C MedScheme
FISHMED DD MHG F
FISHMED P&C MHG F
G GEMS BERYL & SAPPHIRE DD MHG
GEMS BERYL & SAPPHIRE P&C MHG
GEMS EMERALD, ONYX & RUBY DD MHG
GEMS EMERALD, ONYX & RUBY P&C MHG
GENESIS COMPREHENSIVE CHRONIC Genesis F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) N
GENESIS COMPREHENSIVE PMB CHRONIC Genesis F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) Y
GENESIS PRIVATE PLUS CHRONIC Genesis F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) N
GENESIS PRIVATE PLUS & COMPREHENSIVE ACUTE Genesis F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64 Max R29.64 N
GENESIS PRIVATE PLUS PMB CHRONIC Genesis F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) Y
GOLDEN ARROW DD MHG F
GOLDEN ARROW P&C MHG F
GOLDFIELDS DD Providence F
GOLDFIELDS P&C Providence F
GOLDFIELDS PRIDE GP P&C Prime Cure
GRINTEK DD Universal Health F
GRINTEK P&C Universal Health F
H HARMONY HEALTH SERVICES DD Providence F
HARMONY HEALTH SERVICES P&C Providence F
I IBM DD Discovery F
IBM P&C Discovery F
IMPALA DD Providence F
IMPALA P&C Providence F
IMPERIALMED DD MHG
IMPERIALMED P&C MHG
K KEYCARE DD Discovery F
KEYCARE P&C Discovery F
KEYHEALTH EQUILIBRIUM ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH EQUILIBRIUM CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH EQUILIBRIUM GP & SPECIALIST PMSA F R0-R100: 41.04%
>R100.01; R41.04		 R0-R100: 41.04%
>R100.01; R41.04		 Y
KEYHEALTH ESSENCE ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH ESSENCE CHRONIC (PMB ONLY) PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH ESSENCE GP & SPECIALIST PMSA F R0-R100: 41.04%
>R100.01; R41.04		 R0-R100: 41.04%
>R100.01; R41.04		 Y
KEYHEALTH GOLD ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH GOLD CHRONIC (PMB ONLY) PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH GOLD GP & SPECIALIST PMSA F R0-R100: 41.04%
>R100.01; R41.04		 R0-R100: 41.04%
>R100.01; R41.04		 Y
KEYHEALTH PLATINUM ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH PLATINUM CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH PLATINUM GP & SPECIALIST PMSA F R0-R100: 41.04%
>R100.01; R41.04		 R0-R100: 41.04%
>R100.01; R41.04		 Y
KEYHEALTH SILVER ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH SILVER CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 0-R64.99: 34.20&, Max R22.80 Y
KEYHEALTH SILVER GP & SPECIALIST PMSA F R0-R100: 41.04%
>R100.01; R41.04		 R0-R100: 41.04%
>R100.01; R41.04		 Y
L LA HEALTH DD Discovery F
LA HEALTH KEYCARE DD Discovery F
LA HEALTH KEYCARE P&C Discovery F
LA HEALTH P&C Discovery F
LIBCARE DD VMed
LIBCARE P&C VMed
LIBERTY DD MedScheme
LIBERTY P&C MedScheme
LONMIN DD Discovery F
LONMIN P&C Discovery F
M MAMOTH DD ACUTE Mamoth Health Y R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) N
MAMOTH DD CHRONIC Mamoth Health Y R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) N
MASSMART DD MedScheme
MASSMART P&C MedScheme
MBMED DD MedScheme
MBMED P&C MedScheme
MEDIHELP DD Medihelp F
MEDIHELP P&C Medihelp F
MEDIMED DD Providence F
MEDIMED P&C Providence F
MEDIPOS DD MHG F
MEDIPOS P&C MHG F
MEDSHIELD DD Medshield
MEDSHIELD P&C Medshield
METROCARE FULL BENEFIT DD MedScheme
METROCARE FULL BENEFIT P&C MedScheme
METROPOLITAN STAFF DD MHG
METROPOLITAN STAFF P&C MHG
MINEMED AFFORDABLE GP P&C Prime Cure
MINEMED DD Providence F
MINEMED P&C Providence F
MOMENTUM ACCESS (MEDICROSS) GP P&C Prime Cure
MOMENTUM ACCESS (MEDICROSS) SPECIALIST P&C Prime Cure
MOMENTUM ACCESS GP P&C Prime Cure
MOMENTUM ACCESS SPECIALIST P&C Prime Cure
MOMENTUM DD Momentum F
MOMENTUM P&C Momentum F
MOREMED DD Lethimvula
MOREMED P&C lethimvula
MOTO HEALTHCARE DD Momentum F
MOTO HEALTHCARE P&C Momentum F
N NAMPAK DD Momentum F
NAMPAK P&C Momentum F
NATIONAL BARGAINING COUNCIL FOR THE ROAD FREIGHT AND LOGISTICS INDUSTRY (NBCRFLI) DD Universal Health
NATIONAL BARGAINING COUNCIL FOR THE ROAD FREIGHT AND LOGISTICS INDUSTRY (NBCRFLI) P&C Universal Health
NASPERS DD Discovery F
NASPERS MMED DD Discovery F
NASPERS MMED P&C Discovery F
NASPERS P&C Discovery F
NEDGROUP P&C Medscheme
NETCARE DD MHG
NETCARE P&C MHG
NIMAS DD MHG F
NIMAS P&C MHG F
O OM STAFF DD Medscheme
OM STAFF P&C Medscheme
P PARMED DD Medscheme
PARMED P&C Medscheme
PG GROUP DD MHG
PG GROUP P&C MHG
PICK N PAY ACUTE MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PICK ‘N PAY CHRONIC MHG F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PICK N PAY P&C MHG F
POLMED DD MHG
POLMED P&C MHG
PROFMED PROACTIVE GP & SPECIALIST (AUTHORISED PMB AND SCREENING TESTS ) PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROACTIVE PMB CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROPINACCLE CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROPINNACLE ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROPINNACLE GP & SPECIALIST PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROSECURE ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROSECURE CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROSECURE GP & SPECIALIST PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROSECURE PLUS ACUTE PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROFMED PROSECURE PLUS CHRONIC PMSA F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
PROSANO DD Prosano
PROSANO P&C Prosano
Q QUANTUM DD Discovery F
QUANTUM KEYCARE DD Discovery F
QUANTUM KEYCARE P&C Discovery F
QUANTUM P&C Discovery F
R RAND WATER PLAN A ACUTE Rand Water F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RAND WATER PLAN A CHRONIC Rand Water F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) N
RAND WATER PLAN B PLUS ACUTE Rand Water F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RAND WATER PLAN B PLUS CHRONIC Rand Water F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
REMEDI DD Discovery F
REMEDI P&C Discovery F
RESOLUTION FOUNDATION CHRONIC (PMB ONLY) Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION HOSPITAL CHRONIC (PMB ONLY) Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PRESTIGE ACUTE Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PRESTIGE CHRONIC Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PROGRESSIVE FLEX ACUTE Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PROGRESSIVE FLEX CHRONIC (PMB ONLY) Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PROGRESSIVE SAVER ACUTE Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION PROGRESSIVE SAVER CHRONIC (PMB ONLY) Agility Global Health F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 29.64% Max R29.64 (Incl VAT) Y
RESOLUTION HL P&C Agility Global Health F
RETAIL DD Discovery F
RETAIL P&C Discovery F
RUMED DD Providence F
RUMED P&C Providence F
S SABC DD MedScheme
SABC P&C MedScheme
SAB ESSENTIAL ACUTE Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAB ESSENTIAL CHRONIC Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAB ESSENTIAL GP Momentum F
SAB COMPREHENSIVE GP & SPECIALIST Momentum F
SAB COMPREHENSIVE ACUTE Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAB COMPREHENSIVE CHRONIC Momentum F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAMWUMED DD SAMWUMED F
SAMWUMED P&C SAMWUMED F
SAPPI ACUTE MHG R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAPPI CHRONIC MHG R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
SAPPI P&C MHG
SASOLMED DD MedScheme
SASOLMED P&C MedScheme
SELFMED DD VMED
SELFMED P&C VMED
SIZWE DD Sizwe
SIZWE P&C Sizwe
SPECTRAMED DD VMED
SPECTRAMED P&C VMED
SUREMED EXPLORER GP P&C Prime Cure
SUREMED HEALTH DD Providence F
SUREMED HEALTH P&C Providence F
SWAZIMED DD MedScheme
SWAZIMED P&C Medscheme
T TFG DD (Formerly Foschini) Discovery F
TFG P&C (Formerly Foschini) Discovery F
THLAKANO LEGALWISE GP P&C Prime Cure
THLAKANO BASIC GP P&C Prime Cure
THLAKANO COMPREHENSIVE GP P&C Prime Cure
THLAKANO MAHALA GP P&C Prime Cure
THLAKANO MBD GP P&C Prime Cure
THLAKANO MBP-MED GP P&C Prime Cure
THLAKANO MDB-HEALTH GP P&C Prime Cure
THLAKANO ST DAVIDS SCHOOL GP P&C Prime Cure
TIGER BRANDS DD Universal Health F
TIGER BRANDS P&C Universal Health F
TOPMED DD Momentum F
TOPMED P&C Momentum F
TRANSMED DD MHG F
TRANSMED P&C MHG F
TRANSMED STATE & NETWORK GP P&C Prime Cure
TRANSMED STATE & NETWORK SPECIALIST P&C Prime Cure
TSOGO DD Discovery F
TSOGO P&C Discovery F
U UMVUZO STANDARD GP P&C Prime Cure
UMVUZO ULTRA AFFORDABLE GP P&C Prime Cure
UNIVERSITY OF KWA-ZULU NATAL DD Discovery F
UNIVERSITY OF KWA-ZULU NATAL P&C Discovery F
UNIVERSITY OF WITWATERSRAND DD MedScheme
UNIVERSITY OF WITWATERSRAND P&C MedScheme
W WITBANK COALFIELDS ACUTE WCMAS F R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) 36 Y
WITBANK COALFIELDS GP & SPECIALIST WCMAS F
WOOLTRU DD MHG F
WOOLTRU P&C MHG F
WORKER PLAN DD Universal Health F
WORKER PLAN P&C Universal Health F
X XSTRATA ALLOYS DD MedScheme
XSTRATA ALLOYS P&C MedScheme
Bitmap

LEGEND:
MMAP = Maximum Medical Scheme Price
REF = Reference Pricing
REF = Reference Pricing
REF = Reference Pricing
REF = Reference Pricing
URP = Unit Reference Pricing
MMAP, REF or URP: If Y, one or more may apply, if N, None Applies
FAMCHECK/AUTHCHECK (Dependant on Vendor Development): F = FamilyCheck, A= AuthCheck, Blank = Not available
CLAIM TYPE: DD = Dispensing, P&C = Procedures and Consults
OPTION TYPE: HL = Delivery ONLY, P = Processing
PRICING: Y= Yes, Blank = No
Consultation and Procedure Tariffs: as per NRPL Guidelines

Validate Medical Aid Patients before Treating them

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The following medical aids are now live:

  • Afrisam
  • Afrox
  • Alliance Midmed
  • Altron
  • Anglo Medical
  • Anglovaal
  • Bankmed
  • Bepmed
  • CAMAF
  • Cape Medical Plan
  • De Beers
  • Discovery
  • Edcon
  • Foschini
  • Genesis
  • IBM
  • Ingwe
  • Keyhealth
  • LA Health
  • Lonmin
  • Medihelp
  • Medipos
  • MMED (Naspers)
  • MOTO Healthcare
  • Nampak
  • Netcare
  • Oxygen
  • PG
  • Pick ‘n Pay
  • Quantum
  • Rand Water
  • Remedi
  • Resolution
  • Retail
  • SABMAS Castellion
  • SABMAS SAB
  • SAMWUMED
  • Topmed
  • Tsogo
  • University of KZN
  • Witbank Coalfields
  • World Bank

 

 

Check for Valid Medical Aid Benefits 24/7 – not just during office hours. Real-time. See http://www.memcheck.co.za

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