1. New Mamoth Health Scheme Information:
Mamoth Health, a self administered scheme, will be processing via MediKredit with effect from 1 February 2012. New acute and chronic option codes as indicated in the summary table have been assigned for the processing of all plans.
a) Claims should be submitted via HealthNet
b) Retain original scripts for record and audit purposes
HealthNet will validate:
a) Membership number
b) Date of birth
c) Dependent Code
HealthNet will accommodate all networks as agreed to with the scheme.
2.4 Mark‐up & Dispensing Fee
a) Schedule 0 and non‐scheduled items calculated on published wholesale price : 29.64% (Incl. VAT)
b) Schedule 1 to 7 calculated on Single Exit Price Pharmacy Claim (with Prescription): 29.64% ‐ Max R29.64 (Incl. VAT)
2.5 Membership Number
a) Total length: 9 digits
2.6 Stale Claim Period
2.7 On‐line Reversal Period
3. PAYMENT INFORMATION
MediKredit will be paying providers on behalf of the scheme.
SUMMARY OF RULES:
Momoth Health Acute
Mamoth Health Chronic
For more info: Medikredit 0860 932 273