IOD WCA COMPENSATION FUND CLAIMS Stale Claims

 

Date: 23 Feb 2018

1. COMPENSATION FUND CLAIMS SUBMITTED VIA MEDIKREDIT

With Immediate effect, the Stale Claim and Reversal Period applicable to Compensation Fund electronic claims submission will be lifted. MediKredit will deliver all old/stale as well as new/current claims received electronically to the Compensation Fund for electronic processing.

2. MASK CHECK

Member details will not be validated against the cardholder file; however the following mask checks will apply:

a) Workman’s Compensation Number/Claim Number /Membership Number

b) Member Surname

c) Patient First Name

d) Patient Initials

e) Date of Birth

f) Patient ID Number

3. STALE CLAIM PERIOD

Unlimited

4. ON-LINE REVERSAL PERIOD

Unlimited

5. MANDATORY FIELDS

If the following mandatory fields are not submitted, claims may be rejected by the Compensation Fund. Please confirm with your Practice Management Software supplier that your system is ready to include these fields.

a) Employer Name

b) Employer Number

c) Employee ID Number

d) Date of Injury

e) Workman’s Compensation Number/Claim Number/Membership Number

6. CLAIM STATUS TRACKING AND SUBMISSION OF SUPPORTING DOCUMENTATION:

Medical service providers and employers registered on the Compensation Fund web site as web users can track the claim status and processing progress on the Compensation Fund web site within 60 days as from electronic claim submission: https://claimstatus.labour.gov.za/EnquiriesClaimStatusWeb/.

Claims can also be queried with the Compensation Fund call centre telephonically on 0860 10 53 50.

Medical service providers will be notified of the claim status via remittance advices distributed by the Compensation Fund. Supporting documentation can also be captured and submitted on the Compensation Fund web site.

SUBMITTING OPTION CODE

COMPENSATION FUND PHCY AND DISP DR DFPDD 619674

PLAN/OPTION OPTION CODE

COMPENSATION FUND HL P&C CFHGP 619682

Switchboard: 011 770 6000

Call Centre: 0860 932 273

Website: www.medikredit.co.za

10 Kikuyu Road, Sunninghill,

Sandton, 2157

Directors: Dr S C P Belamant; W J du Plessis; H G Kotzé

 

FOR THE 2020 IOD WCA GENERAL PRACTITIONER RATES CLICK HERE

 

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