• 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 (formerly, the Competition Board). While the Commission is the investigative and enforcement agency, the Tribunal is the adjudicative body and the Competition Appeal Court considers appeals against decisions of the Tribunal - http://www.compcom.co.za/who-are-we/

    Following a meeting early February 2015, an update of the process was once again provided by the Commission to the relevant stakeholders. The time-frame for the next steps is available on the website of the Commissioner and the following summary is provided merely as a guideline as the dates may be subject to change:

    Date

    Action on subject matter

    1 August 2014

    Call for submissions

    1 August 2014 – 30 October 2015

    Submission receive period

    1 November 2014 –

    31 January 2015

    Analysis of the Information

    1 March 2015 – 30 April 2015

    Public hearings

    1 May 2015 – 31 July 2015

    Analysis and targeted public hearings and information requests

    October 2015

    Publish on provisional findings and further recommendations.

     

    With a significant number of submissions submitted both from private practitioners as well as corporate entities, the expectation is that some medical practitioners will also be requested to participate in the public hearings. SpesNet highly recommends that any request to attend a hearing be forwarded through to your insurance company and that their assistance be sought prior to any statements made. The deadline for comments have been extended for some groups who applied for extension.

    MEDICAL SCHEMES USING THE STATE HOSPITALS AS DSP

    The National Department of Health requested the Council for Medical schemes to bring the following invitation under the urgent attention of the medical schemes utilizing state facilities as DSPs. The invitation can be viewed on the following link:

    http://www.medicalschemes.com/files/extras/NDOHInvitationToConsultativeMeeting20150226.pdf

    The NDoH is planning to discuss recommendation pertaining to the members of low cost medical schemes who are compelled to access state hospitals for treatment and chronic medication.

    PROFESSIONAL DEVELOPMENT PROGRAM 

    The following CEU (CPD) accredited workshops are on offer from SpesNet:

    Key

    Area

    Dates

     A

    Potch / Klerksdorp

    10 - 12 March 2015

     A

    East London

    14 - 16 April 2015

     B

    WITS

    18 April 2015

     C

    Western Cape

    23 April 2015

     

    Key     Workshop / Conference       Ethics     Gen.

    C

    Risk Management Workshop

    6

         0

    Research Methods Workshop

    2

         7

     A

    Practice Made Perfect Conference

    8

         5

    To reserve your seat, kindly send a request through to: events@spesnet.co.za

     

    GEMS MEDICAL SCHEME CLAIMS

    It has been brought under SpesNet attention that GEMS has distributed an updated tariff file. As the file is in an update process again, the tariff on your Practice Management System might not be 100% accurate. In addition, the scheme is also experiencing problems in the processing of the codes 0147, 0109 and 0011. This had led to some claims not being paid.

    No timeline for the rectification of these problems have been provided and as soon as it is conveyed, we will communicate through to the practices.

    In the interim, SpesNet would advice that you hold back on your GEMS medical scheme claims for the next week or two. Where claims run the risk of becoming stale, please submit these to the scheme and keep queries alive (i.e. maximum every 30 days).

     

     

Our partners

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.

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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.