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Dear Partner
Tracking of submitted claims and payment in January 2024
To ensure that sufficient quality assurance was applied for all claims related to some of the benefit changes implemented from 1 January 2024, all claims related to the following benefits will be pended until 19 January 2024 (unless otherwise advised) and as such will not be available on electronic platforms:
1. All consultations and procedure codes related to Chronic conditions
2. Trauma Extender Benefit claims where the member’s condition qualifies
3. Where the MEDR code is billed on the Readmission Prevention Benefit
4. All Sasolmed claims except Pharmacy and Optometry claims (as communicated to providers in December 2023
We will update the HP Zone to keep healthcare providers up to date as the quality assurance process concludes.
Regards,
Electronic Transaction Management
Functional Enablement: Claims Support Services
Discovery Health
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