• 28 Nov 2016

    SpesNews Volume 136

    The volcano has blown its top!

    2016 will be remembered as the year when medical malpractice insurance (MedMal), also known as professional indemnity, reached such epic proportions that many specialists, especially obstetricians, have finally opted out of certain procedures or services. This was brought to a boiling point by a culmination of factors, in…

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    • 29 Sep 2016

    SpesNews Volume 135

    TECHNOLOGY UTILISATION 2

    The previous version of the introduced the changing landscape of patient monitoring and how remote patient biometric monitoring devices can assist in the creation of a highly efficient and optimised specialist practice. It also placed emphasis on the fact that patient healthcare information should ideally be locate…

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    • 30 Aug 2016

    SpesNews Volume 134

    THE UTILISATION OF TECHNOLOGY IN THE CLINICAL SETTING

    As reported in SpesNews Volume 133, there is a huge imbalance between the number of healthcare professionals per population when South Africa is compared to other developed or developing countries. At a time where access to healthcare remains a priority as one of the Millennium Goals, this discrepan…

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    • 29 Jul 2016

    SpesNews Volume 133

    NEW MEDICAL SCHOOL

    After years of campaigning, government has given the green light for the establishment of a much-welcomed 10th medical school in South Africa. This announcement was made last Saturday by the vice chancellor of the Nelson Mandela Metropolitan University (NMMU), Prof Derrick Swartz.

    The decision in favour of the university was giv…

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    • 28 Jun 2016

    SpesNews Volume 132

    FORENSIC AUDITS

    Forensic Audits are still being performed in a very generous manner by the various medical schemes and some of the codes being audited are for procedures performed for ultrasound investigations (specifically heart sonar examinations) and modifier applications (like modifier 0013).

    SpesNet offers assistance with the forensic audits wh…

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    • 27 May 2016

    SpesNews Volume 131

    HPCSA DISCARDS TOP OFFICIALS

    Nearly 6 months after a special ministerial task team probed allegations relating to maladministration, mismanagement and poor governance at the Health Professions Council of South Africa, the HPCSA parted ways with its CEO, COO and Head of legal services (HOLS). The HPCSA is responsible for the education, training, registr…

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    • 13 Apr 2016

    SpesNews Volume 130

    Discovery Health Day Hospital Remuneration

    Discovery Health is offering enhanced remuneration for selected surgeries performed in a day hospital facility. This is being offered to enable increased efficiency alongside the enhanced professional reimbursement in a sustainable manner.

     The Day Surgery Remuneration Enhancement offer is available to any …

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    • 19 Feb 2016

    SpesNews Volume 129

    PCNS PRACTICE NUMBER

    Practices are required to be in possession of an active practice number in order to submit claims to medical schemes. The practice number has to be updated annually and entails a fee that has to be paid to the PCNS (Practice Code Numbering System) via the BHF (Board of Healthcare Funders). Failure to pay the annual PCNS fees will r…

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    • 12 Feb 2016

    SpesNews Volume 128

    NHI U-TURN

    The Minister of Health, Dr Aaron Motsoaledi, indicated that the role of medical schemes would not be as adversely affected as the NHI White Paper initially would have us believe. In a somewhat unexpected change in approach, he indicated that the prohibition of medical schemes to deliver healthcare in its present form would amount to consum…

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    • 13 Jan 2016

    SpesNews Volume 127

    The road to Universal Healthcare Coverage (UHC) has been given a significant push with the release of the NHI (National Health Insurance) White Paper in December last year (2015). The White Paper broadly outlines some key elements and in its entirety warrants meticulous inspection in order to correctly understand and interpret the myri…

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    • 23 Dec 2015

    SpesNews Volume 126

    Please take note that the SpesNet membership fees for 2016 are:

    Plan 2 – R550

    Plan 3 – R720

    2016 is going to be a big year with new and exciting products and enhancements on offer to our valued clients.

     

    The widely anticipated NHI White Paper has finally been released. …

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    • 11 Dec 2015

    National Health Insurance for South Africa

    For more information, click on the following link:

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    • 11 Dec 2015

    Health Professionals Council of South Africa

    For more information, click on the following link:

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    • 30 Nov 2015

    SpesNews Volume 125

    Genesis and PMBs in private sector

    The Supreme Court of Appeal (SCA) in Bloemfontein upheld an appeal last week by the Council for Medical Schemes concerning prescribed minimum benefits (PMBs). The Scheme in question, Genesis Medical Scheme, opposed that it only had to reimburse for services rendered in the public sector as PMBs.

    The difference in i…

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    • 09 Nov 2015

    SpesNews Volume 124

    Outsourcing Practice Administration

    Factors to be consider when a practice service company offers you something which sounds too good to be true ……. because usually it will be too good to be true!

    SpesNet has had regular interaction with our member practices about a Cape based company who offers Practice Management services and advice that could…

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    • 28 Oct 2015

    SpesNews Volume 123

    PAIA MANUAL

    As the 31 December 2015 deadline draw closer, SpesNet would like to once again remind practices of the PAIA section 51 manual that has to be completed and submitted to the SAHRC (South African Human Right Committee). A link to the template for this manual can be found . Electronic submissions of the manual can be forwarded to:

    li…

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    • 14 Oct 2015

    SpesNews Volume 122

    BONITAS STANDARD OPTION

    Practices should please note that all payments on the Bonitas Standard Option has been postponed due to a technical administrative error until further notice. The problem is currently being addressed by MedScheme and will be resolved as soon as possible.

    This error only affect certain claims and is not an indication the M…

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    • 18 Sep 2015

    SpesNews Volume 121

    PMB AT COST AT 2006 RPL + annual CPIX

    This serves as a friendly reminder that comment(s) on the proposed amendments to the regulations to the Medical Schemes Act 131 should be posted within 3 months to

    The Director-General: Health

    Private Bag X828

    Pretoria

    0001

    The particular Government Gazette applicable is 38990, 14 July 2015(

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    • 17 Sep 2015

    Appointment of new Administrator for andministration and managed care services from 2016 - 2018

    Medscheme (Pty) Limited have been appointed the new Administrators of POLMED from 2016 following a rigorous tender process. Metropolitan Health Corporate remains the administrator and managed care provider of POLMED and will continue to render their contracted services until 31 December 2015.

    POLMED members will receive new membership cards effective 1 J…

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    • 31 Jul 2015

    SpesNews Volume 120

    The Medical Schemes Act 131 of 1998 and regulations to the Act have always been a very sensitive area for most practices, patients and medical schemes. The often debated regulation 8 states that medical schemes are required to reimburse for the treatment of Prescribed Minimum Benefit (PMB) conditions at cost. To manage the…

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    • 15 Jul 2015

    SpesNews Volume 119

    Social Media in the spotlight

    The HPCSA is investigating Professor Tim Noakes for “unprofessional conduct”, this after he posted a message on a social media network that a mother should wean her baby with a low carbohydrate, high fat diet. The complaint against Prof Noakes was brought by The Association for Dietetics’ president, Claire Julsing-Strydom…

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    • 23 Jun 2015

    SpesNews Volume 118

    Medical Doctors Coding Manual (MDCM)

    The South African Medical Association (SAMA) previously availed the printed form of the Doctor’s Billing Manual (DBM) up until the 2009 edition. Since then, only an electronic version has been available in the form of the eMDCM. The 2015 edition is now available in printed form and can be ordered from the SAMA websi…

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    • 18 May 2015

    SpesNews Volume 117

    UPDATE ON GEMS REFERALS

    In communication previously received from the scheme, it stated that GEMS patients should nominate a family practitioner for (amongst other things) specialist referrals. This was scheduled to happen latest by 2 April 2015.

    After engaging with the various stakeholders since then, the GEMS Board of Trustees have reassessed the …

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    • 14 Apr 2015

    SpesNews Volume 116

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    Introducing DUXAH - DUX Academy of Healthcare

    The SpesNet Specialist Professional Development Program has become synonymous with quality and excellence. This tradition is set to continue under its new iteration, aptly named DUXAH (the DUX Academy of Healthcare).

    Over 60 Regional events on offer, will now be delivered via DUXAH.

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    • 30 Mar 2015

    SpesNews Volume 115

    REGULATION 8 AGAIN (PMBs at cost)

    According to a 6 March Times article, the South African Municipal Workers' Union Medical Aid (SAMWUMED) and Genesis Medical Scheme have taken Minister of Health, Aaron Motsoaledi, to court to have the regulation requiring cover of prescribed minimum benefits, struck down. The regulation in particular that is causing …

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    • 09 Mar 2015

    Negligence claims affect healthcare

    Motsoaledi: Negligence claims affect healthcare, hike doctors’ fees

    has warned that South Africa is facing a major crisis of doctors, in particular obstetricians and gynaecologists, being reluctant to perform surgeries in fear of medical negligence law…

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    • 09 Mar 2015

    SpesNews Volume 114

    COMPETITION COMMISSION PRIVATE HEALTHCARE

    The Competition Commission is a statutory body constituted in terms of the Competition Act , No. 89 of 1998 (the “Act”). It is one of three, independent competition regulatory authorities established in terms of the Act, with the other two being the Competition Tribunal and the Competition Appeal Court (forme…

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    • 01 Mar 2015

    Saatchi Bill vetoed

    Lib Dems veto Saatchi's medical innovation bill Health minister cites 'risk of unintended consequences' of law to allow doctors to use innovative treatments when other options are exhausted Press Association Sunday 1 March 2015 05.35 GMT 

    The Liberal Democ…

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    • 01 Feb 2015

    SpesNews Volume 113

    THE CERTIFICATE OF NEED (CON) INVALIDATED

    The Constitutional Court declared the proclamation made by President Zuma regarding the requirement for a Certificate of Need, invalid. The deadline of 01 April 2015 (no pun intended regarding the date) for application for the certificate is no longer cause for concern.

    The grounds for the invalidation are…

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    • 28 Jan 2015

    Con Court Declares ‘Certificate Of Need’ Invalid

    The Constitutional Court on Tuesday ruled President Jacob Zuma’s decision to sign a proclamation forcing doctors to obtain permission before they find work at any private practice as “irrational and invalid.”

    Zuma signed into law sections 36 to 40 of the National Health Act in March last year. The sections were meant to ensure an “equitable spread” of he…

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    • 18 Dec 2014

    SpesNews Vol 112

     COMPETITION COMMISSION ENQUIRY

    The BHF tendered a document to the Competition Commissioner detailing areas it identified as being restrictive in terms of access to healthcare and inefficient processes within the healthcare system. Its submission centers around a comprehensive review of current legislation and the belief that the healthcare market is u…

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    • 12 Nov 2014

    SAMA rejects simplistic BHF report on private health costs

    SAMA rejects simplistic BHF report on private health costs

    The South African Medical Association (SAMA) is perturbed by the current hysteria and furore in the media following the publication by the Rapport newspaper of selective quotes from allegations made by the Board of Healthcare Funders (BHF) in their submission to the Competition Commission’s …

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Our partners

EthiQal is a comprehensive Medical Indemnity solution developed for South African Medical Practitioners by Constantia Insurance Company Limited. Local risk assessment based on South African private sector settlements only. Specialty focused support and inputs to practice management. Provision of Occurrence and Claims Made insurance cover. Insurance contracts which are enforceable in terms of South African law and Regulations.

DUXAH, The DUX Academy of Healthcare, evolved from within SpesNet, a company established by medical specialists to assist medical specialists and recently qualified registrars to negotiate the fraught business of private practice.

Optimising practice income! Get all the power, functionality, and flexibility your Specialist practice needs, plus the convenience of the Web.

ProfNet provides business management tools and practice support to maximise the income and efficiencies of private practice in the South African Allied Healthcare environment.

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When Discovery was established as a small specialist health insurer two decades ago, we made a clear and profound promise: to make people healthier. Making people healthier and enhancing and protecting their lives has evolved into our core purpose.