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Codes: 0130 and 0132 Combined

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Telemedicine: you CAN combine 0130 with 0132
Dear Shareholders and Members

 

According to billing guidelines from SAMA MDCM 2020 for code 0190- 0192, and code 0130 – 0133.

1.     Billing rules applied to codes are based on guidelines provided in the coding guide (SAMA MDCM 2020) and units allocated to the codes.

a.     SAMA MDCM is clear that code 0190- 0192 includes the writing of prescription, repeat prescription and sick notes (see attached)

b.     Code 0130- 0133 do not have such guidelines.

2.     Units allocated to codes

a.     Code 0130 can be billed with 0132/ 0133.

b.     This is because the units assigned to code 0130 excludes costs for code 0132 unlike the usual consultation codes 0190- 0192.

I trust this provides clarity that code 0130 can be billed with code 0132/ 0133.

(MDCM Interpretations – Medical Doctors’ Coding Manual Interpretations)

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Dispensing Fee Adjustment – Doctors (GPs)

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Need some assistance with Dispensing Fee, SEP’s and NAPPI Codes? Click here

 

According to the Government Gazette number 35698 dated 17 September 2012, the dispensing markup has been adjusted.
The new markup structure is as follows (excluding VAT):
Percentage:  30%
Threshold: R90
Fixed markup above threshold: R27.00
Inclusive of 14% VAT as follows:
Percentage: 30%
Threshold: R102.60
Fixed markup above threshold: R30.78
To put this into effect in Medinol:
Main menu -> Process -> Command Print.
At the command prompt, enter SYSMAINT … then adjust
the entries at the bottom of the first page.
Continue pressing Enter through all the remaining pages, then enter EXIT to return to the Medinol Main Menu.
Exit from Medinol back to the Windows Desktop, then reenter for the changes to take effect.

EDI Destination codes: 2020-05-18

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EDI Destination Updates for May 2020

Below are the latest medical aid scheme activation and destination codes.

Medinol Users to Omit the O”P” and use only the numeral.

 

PLEASE NOTE: An * (Asterisk) in front of a Code indicates a change existing destination or a new destination on the list.

 

[pdf-embedder url=”https://medinol.co.za/wp-c0ntent/uploads/2020/05/EDI-DESTINATION-CODES-May-2020.pdf” title=”EDI DESTINATION CODES May 2020″]

Brought to you by Medinol Billing & Claims Software

Momentum Health 6 digit Tariff Codes

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Momentum Health 6 digit Tariff Codes

Date: 6 Sep 2018

Medical-Aid-Claims_softwareMOMENTUM CONSULTATION

 

 

NEW CUSTOMIZED TARIFF CODES 181001/181002/181003

Please note that the customized tariff codes as indicated below, have been implemented for Momentum Health Ingwe and Access plan members.

 

The Momentum Health Ingwe Option provides affordable access to entry-level cover. For chronic treatment and day-to-day benefits, such as doctors visits or prescribed medicine, members are restricted to Ingwe Primary Care Network providers.

 

The Momentum Health Chronic Benefit

The Chronic Benefit covers certain life-threatening conditions that need ongoing treatment. On the Ingwe Option, chronic benefits are available from the Ingwe Primary Care Network. Chronic cover is provided for 26 conditions according to the Chronic Disease List (CDL), which forms part of the Prescribed Minimum Benefits (PMBs). Chronic benefits are subject to registration and approval.

 

The Momentum Health Day-to-day Benefit

This benefit provides for day-to-day medical expenses, such as doctors visits, prescribed medicine etc. On the Ingwe Option, day-to-day benefits are available from the Ingwe Primary
Care Network.

 

The Momentum Health, Health Platform Benefit

The Health Platform Benefit is available from the Ingwe Primary Care Network. This benefit encourages health awareness, enhances the quality of life and gives peace
of mind through:

  • preventative care
  • early detection
  • maternity programme
  • management of certain diseases
  • health education and advice; and
  • local emergency cover.

The new 6-digit Tariff codes must be used for 2013 claims, submitted on the option indicated in the option code table below.

TARIFF CODES TABLE

Consultation                  Tariff Code: 181001

Consultation & Procedure        Tariff Code: 181002

Chronic Registration               Tariff Code: 181003

For actual fees applicable to the above please contact Momentum Health Medical Aid.

Announcement:

If you are a Medinol user, please be advised that Medinol Software Update 4.98 caters for this requirement in full. It may be obtained directly here.

The following screenshot shows Medinol’s implementation:

181001

Please contact us at info@medinol.co.za for more info/advice.

 

Medical-Aid-Claims_software

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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:

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Founder and CEO
Email: info@medinol.co.za
Ph: 021-906-2296
Cell: 082-688-9610

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