How Discovery pays for 0199
From 4 September 2015, Discovery Health will be automating the payment of code 0199 for the reimbursement of all confirmed and approved PMB conditions on the Chronic Disease List that meet the legislative requirements for funding. (Code 0199 – Completion of chronic medication forms by medical practitioners with or without the physical presence of the patient requested by or on behalf of a third party funder or its agent.)
Please be aware that PMB funding differs from normal scheme funding and as such preferential reimbursement such as direct payment arrangements or other unique payment agreements do not apply.
Reimbursement will therefore be made according to the Discovery Health Rate tariff schedule available on www.discovery.co.za. This will apply to all DHMS and In-House plans, except AMS (Anglo Medical Scheme).
Please feel free to email us at firstname.lastname@example.org if you need further information about this.
Our medical aid claims software caters in full for this.
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