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Search Results
Found 352 document (s) (in less than a millisecond) that matched query 'Not applicable':----------------------------------------------------------------------------------------------------------
Hypothyroidism.pdf
Copyright: Council for Medical Schemes Page 1 of 2 HYPOTHYROIDISM Serum TSH Normal Consider sub-clinical hypothyroidism Overt hypothyroidism Normal But TSH > 10 No further testing Clinical symptoms suggestive of hypothyroidism Elevated TSH Do FT4 Start thyroxine 50µg/day for
Copyright: Council for Medical Schemes Page 1 of 2 HYPOTHYROIDISM Serum TSH Normal Consider sub-clinical hypothyroidism Overt hypothyroidism Normal But TSH > 10 No further testing Clinical symptoms suggestive of hypothyroidism Elevated TSH Do FT4 Start thyroxine 50µg/day for
Weighting score:0.492313
Circular_4_2003.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.4019718
Addisons.pdf
Copyright: Council for Medical Schemes Page 1 of 2 ADDISONS DISEASE Diagnosis Oral corticosteroid replacement in divided doses Adjust to individual needs In stressed ill patients dose must be increased Defective aldosterone secretion and/or still insufficient mineral corticoid effect Add fludrocortisone 50-100µg
Copyright: Council for Medical Schemes Page 1 of 2 ADDISONS DISEASE Diagnosis Oral corticosteroid replacement in divided doses Adjust to individual needs In stressed ill patients dose must be increased Defective aldosterone secretion and/or still insufficient mineral corticoid effect Add fludrocortisone 50-100µg
Weighting score:0.4019718
Bronchiectasis.pdf
Copyright: Council for Medical Schemes Page 1 of 2 BRONCHIECTASIS Further antibiotic therapy should be based on sputum microscopic culture and sensitivity investigations Life style modifications No smoking and avoid other irritants Postural drainage
Copyright: Council for Medical Schemes Page 1 of 2 BRONCHIECTASIS Further antibiotic therapy should be based on sputum microscopic culture and sensitivity investigations Life style modifications No smoking and avoid other irritants Postural drainage
Weighting score:0.4019718
ChrohnsDisease.pdf
Copyright: Council for Medical Schemes Page 1 of 2 CROHNS DISEASE Diagnosis Mild-moderate disease Oral corticosteroids Possibly oral antibiotics e.g. metronidazole or a quinolone Severe disease and or abscess IV corticosteroids with or without antibiotics YES Refer for surgical intervention Review Post-operative recurrence azathioprine or methotrexate with corticosteroid YES Taper corticosteroid gradually
Copyright: Council for Medical Schemes Page 1 of 2 CROHNS DISEASE Diagnosis Mild-moderate disease Oral corticosteroids Possibly oral antibiotics e.g. metronidazole or a quinolone Severe disease and or abscess IV corticosteroids with or without antibiotics YES Refer for surgical intervention Review Post-operative recurrence azathioprine or methotrexate with corticosteroid YES Taper corticosteroid gradually
Weighting score:0.4019718
Diabetes.pdf
Copyright: Council for Medical Schemes Page 1 of 2 DIABETES INSIPIDUS Use lowest dose possible to control symptoms Avoid unplanned treatment withdrawal Patient education essential regarding adherence Rule out and treat any underlying cause
Copyright: Council for Medical Schemes Page 1 of 2 DIABETES INSIPIDUS Use lowest dose possible to control symptoms Avoid unplanned treatment withdrawal Patient education essential regarding adherence Rule out and treat any underlying cause
Weighting score:0.4019718
parkinsons.pdf
Copyright: Council for Medical Schemes Page 1 of 2 PARKINSONS DISEASE Diagnosis Age < 60 YES Consider amantadine or anticholinergics Functionally disabled Levodopa with carbidopa in combination and/or dopamine agonist Levodopa with
Copyright: Council for Medical Schemes Page 1 of 2 PARKINSONS DISEASE Diagnosis Age < 60 YES Consider amantadine or anticholinergics Functionally disabled Levodopa with carbidopa in combination and/or dopamine agonist Levodopa with
Weighting score:0.4019718
Schizophrenia.pdf
Copyright: Council for Medical Schemes Page 1 of 2 SCHIZOPHRENIA Check adherence Use another typical antipsychotic or atypical antipsychotic Make Diagnosis Typical antipsychotic or atypical antipsychotic agent most appropriate and cost effective to suit patients need
Copyright: Council for Medical Schemes Page 1 of 2 SCHIZOPHRENIA Check adherence Use another typical antipsychotic or atypical antipsychotic Make Diagnosis Typical antipsychotic or atypical antipsychotic agent most appropriate and cost effective to suit patients need
Weighting score:0.4019718
SystemicLupusErythematosus.pdf
Copyright: Council for Medical Schemes Page 1 of 2 SYSTEMIC LUPUS ERYTHEMATOSUS Diagnosis Antiphospholid antibodies? Mild to moderate disease, non-organ threatening Severe life-threatening or organ-threatening disease Photosensitivity? Consider: High dose corticosteroids orally or pulse IV or cytotoxic drugs e.g. cyclophosphamide or methotrexate
Copyright: Council for Medical Schemes Page 1 of 2 SYSTEMIC LUPUS ERYTHEMATOSUS Diagnosis Antiphospholid antibodies? Mild to moderate disease, non-organ threatening Severe life-threatening or organ-threatening disease Photosensitivity? Consider: High dose corticosteroids orally or pulse IV or cytotoxic drugs e.g. cyclophosphamide or methotrexate
Weighting score:0.4019718
ulcertaiveColitis.pdf
Copyright: Council for Medical Schemes Page 1 of 2 ULCERATIVE COLITIS Extensive Colitis Oral 5-ASAs Severe colitis may require azathioprine prophylaxis In remission YES Change to oral 5-ASAs and oral corticosteroids Chronic colitis with ill health may be an indication for a colectomy Proctosigmoiditis Toxic megacolon requires urgent surgical consultation Active Oral 5-ASAs
Copyright: Council for Medical Schemes Page 1 of 2 ULCERATIVE COLITIS Extensive Colitis Oral 5-ASAs Severe colitis may require azathioprine prophylaxis In remission YES Change to oral 5-ASAs and oral corticosteroids Chronic colitis with ill health may be an indication for a colectomy Proctosigmoiditis Toxic megacolon requires urgent surgical consultation Active Oral 5-ASAs
Weighting score:0.4019718
SupplyChainManagementOfficer20140414.pdf
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest SUPPLY CHAIN MANAGEMENT OFFICER You will work within the Finance unit of the Council and will report to the Senior Manager: Risk & Performance Management. You will be responsible for: Assisting in the development and implementation of the Supply Chain Management (SCM) policies, procedures and compliance with the applicable legislative framework and requirements; Establishing the bid specification, bid evaluation and bid
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest SUPPLY CHAIN MANAGEMENT OFFICER You will work within the Finance unit of the Council and will report to the Senior Manager: Risk & Performance Management. You will be responsible for: Assisting in the development and implementation of the Supply Chain Management (SCM) policies, procedures and compliance with the applicable legislative framework and requirements; Establishing the bid specification, bid evaluation and bid
Weighting score:0.4019718
Art Therapy 2004.pdf
Art Therapy 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY ART THERAPISTS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent
Art Therapy 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY ART THERAPISTS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent
Weighting score:0.3972333
Physiotherapy 2004.pdf
Physiotherapy 2004 09 Sep 2004 Page 1 of 4 Version 01.11 NATIONAL REFERENCE PRICE LIST IN RESPECT OF PHYSIOTHERAPISTS WITH EFFECT FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to
Physiotherapy 2004 09 Sep 2004 Page 1 of 4 Version 01.11 NATIONAL REFERENCE PRICE LIST IN RESPECT OF PHYSIOTHERAPISTS WITH EFFECT FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to
Weighting score:0.3760102
Circular_67_of_2005_Materials_codes.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.3692347
DiabetesMellitus1_2.pdf
Copyright: Council for Medical Schemes Page 1 of 2 DIABETES MELLITUS TYPE 1 Diagnosis of Type 1 YES Continue management Life style modification Home glucose monitoring essential Monitor HbA1c at 3-6 monthly intervals Insulin
Copyright: Council for Medical Schemes Page 1 of 2 DIABETES MELLITUS TYPE 1 Diagnosis of Type 1 YES Continue management Life style modification Home glucose monitoring essential Monitor HbA1c at 3-6 monthly intervals Insulin
Weighting score:0.3692347
Circular27Of2009_20090903.pdf
Principal Officers Chairpersons of Boards of Trustees Other members of Boards of Trustees Circular 2 7 of 2009 Enq: Ronelle Smit t: +27 (0)12 431 0506 f: +27 (0)12 430 7644 e: r.smit @medicalschemes.com Date: 24
Principal Officers Chairpersons of Boards of Trustees Other members of Boards of Trustees Circular 2 7 of 2009 Enq: Ronelle Smit t: +27 (0)12 431 0506 f: +27 (0)12 430 7644 e: r.smit @medicalschemes.com Date: 24
Weighting score:0.3552963
Circular40of2009_20091222.pdf
To: Medical Schemes Medical Scheme Administrators Service providers & Other relevant stakeholders Ref: CMS_21_12_2009 Enq: C. Burton Durham t: (012) 431 - 0513 f: (012) 430 - 7644 e: c.burtondurham@medicalschemes.com Date: 21 December 2009
To: Medical Schemes Medical Scheme Administrators Service providers & Other relevant stakeholders Ref: CMS_21_12_2009 Enq: C. Burton Durham t: (012) 431 - 0513 f: (012) 430 - 7644 e: c.burtondurham@medicalschemes.com Date: 21 December 2009
Weighting score:0.3552963
Circular_61_of_2005_Dental_therapy_impact.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.3552963
Notice_Of_Appeal_FormB_20090721.pdf
FORM B NOTICE OF INTERNAL APPEAL (Section 75 of the Promotion of Access to Information Act 2000 (Act No. 2 of 2000)) [Regulation 8] STATE YOUR REFERENCE NUMBER: A. Particulars of public body The Information Officer/Deputy Information Officer: B. Particulars of requester/third party who lodges the internal appeal (a) The particulars of the person who lodge the internal appeal must be given below. (b) Proof of the capacity in which appeal is lodged, if applicable, must be attached. (c) If the appellant is
FORM B NOTICE OF INTERNAL APPEAL (Section 75 of the Promotion of Access to Information Act 2000 (Act No. 2 of 2000)) [Regulation 8] STATE YOUR REFERENCE NUMBER: A. Particulars of public body The Information Officer/Deputy Information Officer: B. Particulars of requester/third party who lodges the internal appeal (a) The particulars of the person who lodge the internal appeal must be given below. (b) Proof of the capacity in which appeal is lodged, if applicable, must be attached. (c) If the appellant is
Weighting score:0.3517254
CardiacFailure.pdf
Copyright: Council for Medical Schemes Page 1 of 2 CARDIAC FAILURE Diagnosis All patients should have once only pneumococcal immunisation and annual influenza immunisation Consider ACE inhibitor in all patients Add diuretic if patient is fluid overloaded Use thiazide if normal renal function or
Copyright: Council for Medical Schemes Page 1 of 2 CARDIAC FAILURE Diagnosis All patients should have once only pneumococcal immunisation and annual influenza immunisation Consider ACE inhibitor in all patients Add diuretic if patient is fluid overloaded Use thiazide if normal renal function or
Weighting score:0.3517254
CorononaryArtery.pdf
Copyright: Council for Medical Schemes Page 1 of 2 CORONARY ARTERY DISEASE All patients should receive aspirin 75-325 mg/day (unless contraindicated) Sublingual nitrates for short term control of angina symptoms Regular symptomatic treatment required? NO Continue sublingual nitrates
Copyright: Council for Medical Schemes Page 1 of 2 CORONARY ARTERY DISEASE All patients should receive aspirin 75-325 mg/day (unless contraindicated) Sublingual nitrates for short term control of angina symptoms Regular symptomatic treatment required? NO Continue sublingual nitrates
Weighting score:0.3517254
Glaucoma.pdf
Copyright: Council for Medical Schemes Page 1 of 2 GLAUCOMA Start with - blocker eye drops Review for further medication or surgery Poor response? Check adherence Increase dose if possible Switch to alternative first line agent Inadequate
Copyright: Council for Medical Schemes Page 1 of 2 GLAUCOMA Start with - blocker eye drops Review for further medication or surgery Poor response? Check adherence Increase dose if possible Switch to alternative first line agent Inadequate
Weighting score:0.3517254
hyperlipidaema.pdf
Copyright: Council for Medical Schemes Page 1 of 3 HYPERLIPIDAEMIA Manifest coronary heart disease? Other risk factors? E.g. diabetes, smoking, hypertension Lifestyle modification Follow-up in 5 years Characterise hyperlipidaemia Full risk assessment, Fasting TG, TC, HDLC, LDLC Screen for secondary causes e.g. diabetes, hypothyroidism
Copyright: Council for Medical Schemes Page 1 of 3 HYPERLIPIDAEMIA Manifest coronary heart disease? Other risk factors? E.g. diabetes, smoking, hypertension Lifestyle modification Follow-up in 5 years Characterise hyperlipidaemia Full risk assessment, Fasting TG, TC, HDLC, LDLC Screen for secondary causes e.g. diabetes, hypothyroidism
Weighting score:0.3517254
RheumathoidArthritis.pdf
Copyright: Council for Medical Schemes Page 1 of 2 RHEUMATOID ARTHRITIS Active erosive disease? Non drug measures (rest, range-of-motion exercises) and add NSAID Adequate response? NO YES Continue therapy Add a DMARD e.g. methotrexate or sulphasalazine
Copyright: Council for Medical Schemes Page 1 of 2 RHEUMATOID ARTHRITIS Active erosive disease? Non drug measures (rest, range-of-motion exercises) and add NSAID Adequate response? NO YES Continue therapy Add a DMARD e.g. methotrexate or sulphasalazine
Weighting score:0.3517254
PCNSTenderAdvert20120524.pdf
Hadefields Office Park Block E 1267 Pretorius Street Hatfield 0028 The Council for Medical S chemes (CMS) was established in terms of the Medical Schemes Act (MSA) 131 of 1998 to provide regulatory oversight to the medical schemes industry. The CMS is a public entity listed under Schedule 3A
Hadefields Office Park Block E 1267 Pretorius Street Hatfield 0028 The Council for Medical S chemes (CMS) was established in terms of the Medical Schemes Act (MSA) 131 of 1998 to provide regulatory oversight to the medical schemes industry. The CMS is a public entity listed under Schedule 3A
Weighting score:0.3517254
EVGuidelineVer62013.pdf
Applicable to cases reported from 1 January 2012 Version 6.1: Guidelines for the Identification of B eneficiaries with Risk Factors 1 Table of Contents Changes made to Version 6.1 since the publication o f Version 5 of the guidelines on 09 March 2010. ...................... ................................................... .. 3 1. Introduction ................................... ................................................... ................... 4 2. Implementation Date ............................... ................................................... ....... 6 Existing CDL Cases .................................................. ................................................... ... 6All CDL Cases .................................................. ................................................... ............ 6Note on Cases Identified with Previous Versions of the Guidelines ............................... 6 3. Preparation of Grids .............................. ................................................... ......... 7 General .................................................. ................................................... ....................... 7Age Bands .................................................. ................................................... .................. 7CDL Cases .................................................. ................................................... ................. 7Multiple Chronic Conditions ................................................... .......................................... 8Exclusion of Specific Diseases as Multiple Chronic conditions in the Count Grids
Applicable to cases reported from 1 January 2012 Version 6.1: Guidelines for the Identification of B eneficiaries with Risk Factors 1 Table of Contents Changes made to Version 6.1 since the publication o f Version 5 of the guidelines on 09 March 2010. ...................... ................................................... .. 3 1. Introduction ................................... ................................................... ................... 4 2. Implementation Date ............................... ................................................... ....... 6 Existing CDL Cases .................................................. ................................................... ... 6All CDL Cases .................................................. ................................................... ............ 6Note on Cases Identified with Previous Versions of the Guidelines ............................... 6 3. Preparation of Grids .............................. ................................................... ......... 7 General .................................................. ................................................... ....................... 7Age Bands .................................................. ................................................... .................. 7CDL Cases .................................................. ................................................... ................. 7Multiple Chronic Conditions ................................................... .......................................... 8Exclusion of Specific Diseases as Multiple Chronic conditions in the Count Grids
Weighting score:0.346186
EVGlVer72013.pdf
Applicable to cases reported from 1 January 2013 Version 7.0: Guidelines for the identification of beneficiaries with risk factors 1 Draft Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 7.0 Applicable from 1 January 2013 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical
Applicable to cases reported from 1 January 2013 Version 7.0: Guidelines for the identification of beneficiaries with risk factors 1 Draft Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 7.0 Applicable from 1 January 2013 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical
Weighting score:0.3440142
VersionFiveOfEnVGuidelines.pdf
Guidelines for the Identification of Beneficiaries with REF R isk Factors in A ccordance with the REF Entry and Verification Criteria V ersion 5 Applicable f r o m 1 January 2010 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry .
Guidelines for the Identification of Beneficiaries with REF R isk Factors in A ccordance with the REF Entry and Verification Criteria V ersion 5 Applicable f r o m 1 January 2010 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry .
Weighting score:0.338232
GIBRFAE.pdf
Guidelines for the Identification of Beneficiaries with R isk Factors in A ccordance with the Entry and Verification Criteria V ersion 6 Applicable from 1 January 201 3 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 05
Guidelines for the Identification of Beneficiaries with R isk Factors in A ccordance with the Entry and Verification Criteria V ersion 6 Applicable from 1 January 201 3 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 05
Weighting score:0.3353035
20131121Ver71EVGuidelines.pdf
Draft Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 7.1 Applicable from 1 January 2013 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry 27 January 2014 Applicable to cases reported from 1 January 2013 Version 7.1: Guidelines for the identification of beneficiaries
Draft Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 7.1 Applicable from 1 January 2013 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry 27 January 2014 Applicable to cases reported from 1 January 2013 Version 7.1: Guidelines for the identification of beneficiaries
Weighting score:0.3353035
V4_of_Entry_and_Verification_Guidelines.pdf
Guidelines for the Identification of Beneficiaries with REF R isk Factors in A ccordance with the REF Entry and Verification Criteria V ersion 4 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 06 OCTOBER 2008
Guidelines for the Identification of Beneficiaries with REF R isk Factors in A ccordance with the REF Entry and Verification Criteria V ersion 4 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 06 OCTOBER 2008
Weighting score:0.3353035
EV8Guidfl.pdf
Draft Guidelines for the Identification of Beneficiaries with R isk Factors in A ccordance with the Entry and Verification Criteria V ersion 8.0 Applicable from 1 January 201 4 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to
Draft Guidelines for the Identification of Beneficiaries with R isk Factors in A ccordance with the Entry and Verification Criteria V ersion 8.0 Applicable from 1 January 201 4 Council for Medical Schemes The Council for Medical Schemes (CMS) was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to
Weighting score:0.3293685
Occupational Therapy 2004.pdf
Occupational Therapy 2004 09 Sep 2004 Page 1 of 5 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OCCUPATIONAL THERAPISTS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent
Occupational Therapy 2004 09 Sep 2004 Page 1 of 5 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OCCUPATIONAL THERAPISTS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent
Weighting score:0.3177867
Circular_45_of_2006_with_Algorythms.pdf
Chairperson: Prof. William Pick Vice-Chairperson: Dr S aadiq Kariem Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) 1 Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. William Pick Vice-Chairperson: Dr S aadiq Kariem Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) 1 Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.3097401
ChronicRenalDisease.pdf
Copyright: Council for Medical Schemes Page 1 of 3 CHRONIC RENAL DISEASE Mild Chronic Renal Failure (Cr 100-200µmol/l) Moderate Chronic Renal Failure (Cr 200-400µmol/l) Treat hypertension vigorously i.e. BP < 130/85 mmHg Avoid diuretics unless volume overloaded Usually 3 agents required especially when Cr
Copyright: Council for Medical Schemes Page 1 of 3 CHRONIC RENAL DISEASE Mild Chronic Renal Failure (Cr 100-200µmol/l) Moderate Chronic Renal Failure (Cr 200-400µmol/l) Treat hypertension vigorously i.e. BP < 130/85 mmHg Avoid diuretics unless volume overloaded Usually 3 agents required especially when Cr
Weighting score:0.3076956
DiabetesMellitus2_3.pdf
Copyright: Council for Medical Schemes Page 1 of 3 DIABETES MELLITUS TYPE 2 Measure HbA1c every 3 months depending on control and changes in therapy Continue to monitor HbA1c every 6 months Target HbA1c should be 7.0% Diagnosis of Type 2 Have lifestyle modifications been successful? YES YES
Copyright: Council for Medical Schemes Page 1 of 3 DIABETES MELLITUS TYPE 2 Measure HbA1c every 3 months depending on control and changes in therapy Continue to monitor HbA1c every 6 months Target HbA1c should be 7.0% Diagnosis of Type 2 Have lifestyle modifications been successful? YES YES
Weighting score:0.3076956
Homoeopaths 2005.pdf
Homoeopaths 2005 13 Feb 2005 Page 1 of 2 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Homoeopaths 2005 13 Feb 2005 Page 1 of 2 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Weighting score:0.3014789
Homoeopaths 2005v2.06.pdf
Homoeopaths 2005 13 Feb 2005 Page 1 of 2 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Homoeopaths 2005 13 Feb 2005 Page 1 of 2 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Weighting score:0.3014789
Asthma.pdf
Copyright: Council for Medical Schemes Page 1 of 3 ASTHMA Made on symptoms and signs Objective measurement: FEV1 improvement possible 15% [& 200ml increase after short acting 2 agonist (400µg MDI and spacer)] Aims of Management: Control symptoms and prevent exacerbations Achieve best possible peak flow Minimise adverse effects Stepwise Approach: Start treatment at step most appropriate to initial severity Achieve early control Maintain
Copyright: Council for Medical Schemes Page 1 of 3 ASTHMA Made on symptoms and signs Objective measurement: FEV1 improvement possible 15% [& 200ml increase after short acting 2 agonist (400µg MDI and spacer)] Aims of Management: Control symptoms and prevent exacerbations Achieve best possible peak flow Minimise adverse effects Stepwise Approach: Start treatment at step most appropriate to initial severity Achieve early control Maintain
Weighting score:0.3014789
Cardiomyopathy.pdf
Copyright: Council for Medical Schemes Page 1 of 2 CARDIOMYOPATHY Diagnosis Consider ACE inhibitor in all p atients Add diuretic if patient is fluid overloaded Use thiazide if normal renal function or Loop diuretic if impaired renal function and volume overloaded o Patients
Copyright: Council for Medical Schemes Page 1 of 2 CARDIOMYOPATHY Diagnosis Consider ACE inhibitor in all p atients Add diuretic if patient is fluid overloaded Use thiazide if normal renal function or Loop diuretic if impaired renal function and volume overloaded o Patients
Weighting score:0.3014789
COPD3rd.pdf
Copyright: Council for Medical Schemes Page 1 of 2 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Stage I FEV1 at least 50% of predicted Mild effort-related dyspnoea Bronchodilators : relieve symptoms, do not alter decline in FEV1 2 agonist inhaler: 2 puffs
Copyright: Council for Medical Schemes Page 1 of 2 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Stage I FEV1 at least 50% of predicted Mild effort-related dyspnoea Bronchodilators : relieve symptoms, do not alter decline in FEV1 2 agonist inhaler: 2 puffs
Weighting score:0.3014789
Disrhytmias.pdf
Copyright: Council for Medical Schemes Page 1 of 4 DYSRHYTHMIAS Chronic Atrial Fibrillation Diagnosis Heart rate controlled: No treatment needed Bradycardia < 60 beats/min Review for permanent pacemaker Heart rate: > 80 beats/min
Copyright: Council for Medical Schemes Page 1 of 4 DYSRHYTHMIAS Chronic Atrial Fibrillation Diagnosis Heart rate controlled: No treatment needed Bradycardia < 60 beats/min Review for permanent pacemaker Heart rate: > 80 beats/min
Weighting score:0.3014789
Epilepsy.pdf
Copyright: Council for Medical Schemes Page 1 of 2 EPILEPSY Primary partial seizures Start with phenytoin or carbamazepine or sodium valproate or valproic acid or phenobarbitone Not tolerated or controlled? Alternatives: Phenytoin or carbamazepine or sodium valproate or valproic acid
Copyright: Council for Medical Schemes Page 1 of 2 EPILEPSY Primary partial seizures Start with phenytoin or carbamazepine or sodium valproate or valproic acid or phenobarbitone Not tolerated or controlled? Alternatives: Phenytoin or carbamazepine or sodium valproate or valproic acid
Weighting score:0.3014789
Haemophilia.pdf
Copyright: Council for Medical Schemes Page 1 of 3 HAEMOPHILIA Haemophilia A Mild Disease Factor VIII 5-40% of the normal value Severe Disease Factor VIII < 1% of the normal value Desmopressin response study All require bleeding charts Home-based action plan Factor VIII available for
Copyright: Council for Medical Schemes Page 1 of 3 HAEMOPHILIA Haemophilia A Mild Disease Factor VIII 5-40% of the normal value Severe Disease Factor VIII < 1% of the normal value Desmopressin response study All require bleeding charts Home-based action plan Factor VIII available for
Weighting score:0.3014789
Circular_51_of_2005_Chemo_guidelines.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2929848
Medical Practitioners 2004.pdf
Medical Practitioners 2004 09 Sep 2004 Page 1 of 13 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL PRACTITIONERS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service provider s can individually determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a parti cular health service is equiva lent to a
Medical Practitioners 2004 09 Sep 2004 Page 1 of 13 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL PRACTITIONERS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service provider s can individually determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a parti cular health service is equiva lent to a
Weighting score:0.2849301
Circular_34_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.284237
MedCouncilAppeal_H.pdf
THE COUNCIL FOR MEDICAL SCHEMES APPEAL COMMITTEE In the matter between: HD
THE COUNCIL FOR MEDICAL SCHEMES APPEAL COMMITTEE In the matter between: HD
Weighting score:0.284237
Press_Release_9.pdf
Press Release 30 August 2000 SARS RULES ON INTEREST IN MEDICAL SAVINGS ACCOUNTS
Press Release 30 August 2000 SARS RULES ON INTEREST IN MEDICAL SAVINGS ACCOUNTS
Weighting score:0.284237
AdvertForExpressionOfInterestBenefitOptionRegistry20111118.pdf
Hadefields Office Park Block E 1267 Pretorius Street Hatfield 0028 The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical scheme indu stry . EXPRESSION OF INTEREST Specifying and building of a comprehensive medical
Hadefields Office Park Block E 1267 Pretorius Street Hatfield 0028 The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical scheme indu stry . EXPRESSION OF INTEREST Specifying and building of a comprehensive medical
Weighting score:0.284237
Medical Practitioners 2006.pdf
Medical Practitioners 2006 05 Sep 2005 Page 5 of 186 Version 2006.03 0015 Intravenous infusions: Where intravenous infusions (including blood and blood cellu lar products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall be charged as this is included in the global operative or maternity fees . Should the practitioner doing the operati on or attending to the maternity case prefer to ask another practitioner to perform post-operative or post-confinement intravenous infusions, t hen the practitioner himself (and not the pa tient) shall be responsible for re munerating such practitioner for the infusions 2004. 00 0017
Medical Practitioners 2006 05 Sep 2005 Page 5 of 186 Version 2006.03 0015 Intravenous infusions: Where intravenous infusions (including blood and blood cellu lar products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall be charged as this is included in the global operative or maternity fees . Should the practitioner doing the operati on or attending to the maternity case prefer to ask another practitioner to perform post-operative or post-confinement intravenous infusions, t hen the practitioner himself (and not the pa tient) shall be responsible for re munerating such practitioner for the infusions 2004. 00 0017
Weighting score:0.2773531
Medical Practitioners 2005v2.06.pdf
Medical Practitioners 2005 20 Jul 2005 Page 5 of 183 Version 02.06 0015 Intravenous infusions: Where intravenous infusions (including blood and blood cellu lar products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall be charged as this is included in the global operative or maternity fees . Should the practitioner doing the operati on or attending to the maternity case prefer to ask another practitioner to perform post-operative or post-confinement intravenous infusions, t hen the practitioner himself (and not the pa tient) shall be responsible for remunerating such practitioner for the infusions
Medical Practitioners 2005 20 Jul 2005 Page 5 of 183 Version 02.06 0015 Intravenous infusions: Where intravenous infusions (including blood and blood cellu lar products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall be charged as this is included in the global operative or maternity fees . Should the practitioner doing the operati on or attending to the maternity case prefer to ask another practitioner to perform post-operative or post-confinement intravenous infusions, t hen the practitioner himself (and not the pa tient) shall be responsible for remunerating such practitioner for the infusions
Weighting score:0.2737742
Medical Practitioners 2005.pdf
Medical Practitioners 2005 14 Feb 2005 Page 5 of 188 Version 02.05 0017 Injections administered by practitioners: W hen desensitisation, intravenous, intramuscular or subcutaneous injections are administered by the prac titioner him-/herself to patients who attend the consulting rooms, a first injection forms a part of the consultation/visit and all subsequent injections for the same condition should be charged at 50 % of the appropriate visit fee for a general practitioner. Not to be charged in c onjunction with a consultation fee. U 7.50069.00 (60.53) 7.50069.00 (60.53) 0018 Surgical modifier for persons with a BM I of 35> (calculated according
Medical Practitioners 2005 14 Feb 2005 Page 5 of 188 Version 02.05 0017 Injections administered by practitioners: W hen desensitisation, intravenous, intramuscular or subcutaneous injections are administered by the prac titioner him-/herself to patients who attend the consulting rooms, a first injection forms a part of the consultation/visit and all subsequent injections for the same condition should be charged at 50 % of the appropriate visit fee for a general practitioner. Not to be charged in c onjunction with a consultation fee. U 7.50069.00 (60.53) 7.50069.00 (60.53) 0018 Surgical modifier for persons with a BM I of 35> (calculated according
Weighting score:0.2664722
Medical Practitioners 2006pluscpix.pdf
Code Description Ver Add Specialists General Practitioners / non-designated Specialists Anaesthesiology RVU Fee RVU Fee RVU Fee 18 Dec 2006 Page 4 of 170 Version 2007.03 0007 a) Use of own monitoring equipment in the rooms: Remuner ation for the use of any type of own monitoring equipment in the rooms for procedures performed under intravenous sedation - 15,00 clinical procedure uni ts irrespective of the number of items of equipment provided. b) Use of own equipment in hospital theatre or unattached t heatre
Code Description Ver Add Specialists General Practitioners / non-designated Specialists Anaesthesiology RVU Fee RVU Fee RVU Fee 18 Dec 2006 Page 4 of 170 Version 2007.03 0007 a) Use of own monitoring equipment in the rooms: Remuner ation for the use of any type of own monitoring equipment in the rooms for procedures performed under intravenous sedation - 15,00 clinical procedure uni ts irrespective of the number of items of equipment provided. b) Use of own equipment in hospital theatre or unattached t heatre
Weighting score:0.2664722
Circular_20_2001.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD Http://www.medicalschemes.com CIRCULAR LETTER 20 OF 2001 COMMENTS INVITED ON REVISE D PROPOSED ACCREDITATION REQUIREMENTS FOR ADMINIST RATORS
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD Http://www.medicalschemes.com CIRCULAR LETTER 20 OF 2001 COMMENTS INVITED ON REVISE D PROPOSED ACCREDITATION REQUIREMENTS FOR ADMINIST RATORS
Weighting score:0.2658794
Medical Practitioners 2006_v04.pdf
Medical Practitioners 2006 04 Nov 2005 Page 4 of 160 Version 2006.04 0010 Local anaesthesic: (a) A fee for a loca l anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater t han 30,00 clinical procedure units (i.e. 31,00 or more clinical procedure units allocated to a single it em) or (2) where more than one operation or procedure is done at the same time with a combined value greater than 50,00 clinical procedure units. (b) The fee shall be calculated according to t he basic anaesthetic units for the specific operation.
Medical Practitioners 2006 04 Nov 2005 Page 4 of 160 Version 2006.04 0010 Local anaesthesic: (a) A fee for a loca l anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater t han 30,00 clinical procedure units (i.e. 31,00 or more clinical procedure units allocated to a single it em) or (2) where more than one operation or procedure is done at the same time with a combined value greater than 50,00 clinical procedure units. (b) The fee shall be calculated according to t he basic anaesthetic units for the specific operation.
Weighting score:0.2627451
APPLICATION FORM FOR THE REGISTRATION OF A NEW SCHEME.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD Http://www.medicalschemes.com
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD Http://www.medicalschemes.com
Weighting score:0.2512324
REQUIREMENTS GUIDELINES FOR THE REGISTRATION OF A NEW MS.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Weighting score:0.2512324
Requirements for registration of medical scheme.pdf
REQUIREMENTS & GUIDELINES TO BE COMPLIED WITH FOR REGISTRATION OF A MEDICAL SCHEME IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT NO 131 OF 1998) PUBLISHED IN GOVERNMENT GAZETTE 19545 ON 2 DECEMBER 1998 1 Submission of a written application for registra tion as contemplated in Section 22, signed by the person managing the business of the proposed scheme together with the prescribed fee. 2 Submission of a written business plan duly motivated which should include:
REQUIREMENTS & GUIDELINES TO BE COMPLIED WITH FOR REGISTRATION OF A MEDICAL SCHEME IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT NO 131 OF 1998) PUBLISHED IN GOVERNMENT GAZETTE 19545 ON 2 DECEMBER 1998 1 Submission of a written application for registra tion as contemplated in Section 22, signed by the person managing the business of the proposed scheme together with the prescribed fee. 2 Submission of a written business plan duly motivated which should include:
Weighting score:0.2512324
REQUIREMENTS-GUIDELINES FOR NEW MS.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Weighting score:0.2512324
Circular_50_of_2006_saica_guidelines.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2512324
Circular_71_of_2005_Consult_codes.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
Weighting score:0.2512324
REQUIREMENTS GUIDELINES FOR THE REGISTRATION OF A NEW MS.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Weighting score:0.2512324
Requirements for registration of medical scheme.pdf
REQUIREMENTS & GUIDELINES TO BE COMPLIED WITH FOR REGISTRATION OF A MEDICAL SCHEME IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT NO 131 OF 1998) PUBLISHED IN GOVERNMENT GAZETTE 19545 ON 2 DECEMBER 1998 1 Submission of a written application for registra tion as contemplated in Section 22, signed by the person managing the business of the proposed scheme together with the prescribed fee. 2 Submission of a written business plan duly motivated which should include:
REQUIREMENTS & GUIDELINES TO BE COMPLIED WITH FOR REGISTRATION OF A MEDICAL SCHEME IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT NO 131 OF 1998) PUBLISHED IN GOVERNMENT GAZETTE 19545 ON 2 DECEMBER 1998 1 Submission of a written application for registra tion as contemplated in Section 22, signed by the person managing the business of the proposed scheme together with the prescribed fee. 2 Submission of a written business plan duly motivated which should include:
Weighting score:0.2512324
REQUIREMENTS-GUIDELINES FOR NEW MS.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATF IELD Http://www.medicalschemes.com
Weighting score:0.2512324
Biokinetics 2004.pdf
Biokinetics 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST IN RESPECT OF BIOKINETICS WITH EFFECT FROM 1 JANUARY 2004 Preamble The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service
Biokinetics 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST IN RESPECT OF BIOKINETICS WITH EFFECT FROM 1 JANUARY 2004 Preamble The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service
Weighting score:0.2512324
Dental Therapy 2004.pdf
Dental Therapy 2004 09 Sep 2004 Page 2 of 3 Version 01.11 003 Appointment not kept (by arrangement with patient) - (-) 004 Examination or consultation for a spec ific problem not requiring full mouth exam ination, charting and treatment planning. 3 8.10 (33.40) 005 Intra-oral radiographs, per film (p eri-apical, bitewing and occlusal). 36.60 (32.10) 007 Maximum for 005 (4 x X-rays). 146.90 (128.90) 009 Use of rubber gloves and masks as part of infection cont rol, per dental therapist, per assistant, per visit. 7.32 (6.42) 011 Panoramic radiograph (By arrangement with scheme). - (-) 013 Additional
Dental Therapy 2004 09 Sep 2004 Page 2 of 3 Version 01.11 003 Appointment not kept (by arrangement with patient) - (-) 004 Examination or consultation for a spec ific problem not requiring full mouth exam ination, charting and treatment planning. 3 8.10 (33.40) 005 Intra-oral radiographs, per film (p eri-apical, bitewing and occlusal). 36.60 (32.10) 007 Maximum for 005 (4 x X-rays). 146.90 (128.90) 009 Use of rubber gloves and masks as part of infection cont rol, per dental therapist, per assistant, per visit. 7.32 (6.42) 011 Panoramic radiograph (By arrangement with scheme). - (-) 013 Additional
Weighting score:0.2512324
Pharmacy_Survey_Questionnaire.pdf
Name of Pharmacy Name of Pharmacy Manager Name of Pharmacy Owner Physical Address of Pharmacy Postal Address Telephone Number of Contact Person Email Address Date Pharmacy opened Floor space of the whole pharmacy (a sketch may be required) Floor space of the area involved with dispensing Type of Location e .g Shopping center, township, hospital, city/town cent, residential. Distance to the closest alternative Pharmacy Number of Pharmacies within a 3km radius . Number of dispensing doctors within a 3km radius Rate of scheduled medicines turnover (Average time the medicine spends on the shelf)
Name of Pharmacy Name of Pharmacy Manager Name of Pharmacy Owner Physical Address of Pharmacy Postal Address Telephone Number of Contact Person Email Address Date Pharmacy opened Floor space of the whole pharmacy (a sketch may be required) Floor space of the area involved with dispensing Type of Location e .g Shopping center, township, hospital, city/town cent, residential. Distance to the closest alternative Pharmacy Number of Pharmacies within a 3km radius . Number of dispensing doctors within a 3km radius Rate of scheduled medicines turnover (Average time the medicine spends on the shelf)
Weighting score:0.2512324
Hypertension.pdf
Copyright: Council for Medical Schemes Page 1 of 4 HYPERTENSION Measure BP in sitting position Systolic<130mmHg and diastolic< 85 mmHg Recheck in 1 year Diabetes? CCF? Systolic 140-159mmHg or diastolic 90-99mmHg Recheck within 2 months Start drug treatment Start drug treatment
Copyright: Council for Medical Schemes Page 1 of 4 HYPERTENSION Measure BP in sitting position Systolic<130mmHg and diastolic< 85 mmHg Recheck in 1 year Diabetes? CCF? Systolic 140-159mmHg or diastolic 90-99mmHg Recheck within 2 months Start drug treatment Start drug treatment
Weighting score:0.2512324
EntryVerificationcriteriacomments.pdf
1 Comments on the Entry and Verification C riteria in general D r a f t C M S S u b m i s s i o n f o r d i s c u s s i o n w i t h R E T A P o n 2 6 M a r c h 2 0 0 9 The following areas of concern in the
1 Comments on the Entry and Verification C riteria in general D r a f t C M S S u b m i s s i o n f o r d i s c u s s i o n w i t h R E T A P o n 2 6 M a r c h 2 0 0 9 The following areas of concern in the
Weighting score:0.2512324
Circular_50_2004.pdf
____________________________________________________________________________________________________ Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Http://www.medicalschemes.com Private Bag X34, HATFIELD, 0028 Phone: +27 (0) 12 431- 0500 Hadefields Block E, 1267 Pretorius Street, HATFIELD Fax: +27 (0) 12 430 -7644
____________________________________________________________________________________________________ Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Http://www.medicalschemes.com Private Bag X34, HATFIELD, 0028 Phone: +27 (0) 12 431- 0500 Hadefields Block E, 1267 Pretorius Street, HATFIELD Fax: +27 (0) 12 430 -7644
Weighting score:0.2487074
ReqForAdministrators_2010020222.pdf
R equirements for M edical S cheme A dministrators February 20 10 1 REQUIREMENTS FOR ADMINISTRAT ION OF MEDICAL SCHEME S
R equirements for M edical S cheme A dministrators February 20 10 1 REQUIREMENTS FOR ADMINISTRAT ION OF MEDICAL SCHEME S
Weighting score:0.2487074
ClinicalAnalyst2012.pdf
The Council for Medical Schemes is the regulatory authority for medical schemes and associated entities, and was established in terms of the Medical Schemes Act 131 of 1998. The following position exists for persons driven by a desire to protect the public interest. CLINICAL ANALYST You will work within the Clinical Unit of the Council, and will report to the Strategist in the Office of the Registrar . You will be part of
The Council for Medical Schemes is the regulatory authority for medical schemes and associated entities, and was established in terms of the Medical Schemes Act 131 of 1998. The following position exists for persons driven by a desire to protect the public interest. CLINICAL ANALYST You will work within the Clinical Unit of the Council, and will report to the Strategist in the Office of the Registrar . You will be part of
Weighting score:0.2487074
Medical Practitioners 2006_v06.pdf
Medical Practitioners 2006 20 Feb 2006 Page 4 of 163 Version 2006.06 0010 Local anaesthesic: (a) A fee for a loca l anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater t han 30,00 clinical procedure units (i.e. 31,00 or more clinical procedure units allocated to a single it em) or (2) where more than one operation or procedure is done at the same time with a combined value greater than 50,00 clinical procedure units. (b) The fee shall be calculated according to t he basic anaesthetic units for the specific operation.
Medical Practitioners 2006 20 Feb 2006 Page 4 of 163 Version 2006.06 0010 Local anaesthesic: (a) A fee for a loca l anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater t han 30,00 clinical procedure units (i.e. 31,00 or more clinical procedure units allocated to a single it em) or (2) where more than one operation or procedure is done at the same time with a combined value greater than 50,00 clinical procedure units. (b) The fee shall be calculated according to t he basic anaesthetic units for the specific operation.
Weighting score:0.2472757
MHCSelfEvaluatingChecklist2011.pdf
Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com Accreditation of Managed Care Organisations THE SELF-EVALUATION CHECKLIST Accreditation Standards for Managed Care Organisations- (Version 4) NOVEMBER 2011 2 | Page Introduction: The current accreditation of managed care organisations process is self-directed with an inherent emphasis on self-evaluation and self-improvement. The purpose of this checklist is to assist applicants to determine readiness for accreditation and to facilitate the smooth conduct of the accreditation process itself. Responses
Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com Accreditation of Managed Care Organisations THE SELF-EVALUATION CHECKLIST Accreditation Standards for Managed Care Organisations- (Version 4) NOVEMBER 2011 2 | Page Introduction: The current accreditation of managed care organisations process is self-directed with an inherent emphasis on self-evaluation and self-improvement. The purpose of this checklist is to assist applicants to determine readiness for accreditation and to facilitate the smooth conduct of the accreditation process itself. Responses
Weighting score:0.2461565
Reg Nurses Private Practice Nursing Agencies 2006_v04.pdf
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Weighting score:0.2461565
Registered Nurses 2005v2.06.pdf
Registered Nurses In Private Practice and Nursing Agencies 2005 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a
Registered Nurses In Private Practice and Nursing Agencies 2005 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a
Weighting score:0.2461565
Registered Nurses and Nursing Agencies 2005.pdf
Registered Nurses In Private Practice and Nursing Agencies 2005 13 Feb 2005 Page 1 of 8 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules
Registered Nurses In Private Practice and Nursing Agencies 2005 13 Feb 2005 Page 1 of 8 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules
Weighting score:0.2461565
Registered Nurses In Private Practice.pdf
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Weighting score:0.2461565
Registered Nursing Agencies 2006_v05.pdf
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Weighting score:0.2461565
Reg_Nurses_and_Nursing_Agencies_2006pluscpix.pdf
Registered Nurses In Private Practice and Nursing Agencies 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Registered Nurses In Private Practice and Nursing Agencies 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Weighting score:0.2461565
Reg_Nurses_Nurse_Agencies_2006_v06.pdf
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Registered Nurses In Private Practice and Nursing Agencies 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSES IN PRIVATE PRACTICE AND NURSING AGENCIES, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth
Weighting score:0.2461565
Approval of Auditors - final and updated 07.03.01_1.pdf
Auditor Approval Forms Information required by the Registrar of Medical Schemes in considering the approval of the appointment of an auditor of a medical scheme Instructions for completion of the questionnaire The form consists of three parts: Part A Appointment by scheme Part B Applicable to the audit firm Part C Applicable to the responsible partner Responsible partner means the auditor respon sible for the effective functioning of all the phases in the audit and for exercising his/her professional judgement, based on the results of the audit procedure, to express an opinion on
Auditor Approval Forms Information required by the Registrar of Medical Schemes in considering the approval of the appointment of an auditor of a medical scheme Instructions for completion of the questionnaire The form consists of three parts: Part A Appointment by scheme Part B Applicable to the audit firm Part C Applicable to the responsible partner Responsible partner means the auditor respon sible for the effective functioning of all the phases in the audit and for exercising his/her professional judgement, based on the results of the audit procedure, to express an opinion on
Weighting score:0.23834
Circular_15_2001.pdf
REQUIREMENTS FOR ACCREDITATION OF ADMINISTRATORS The Trustees are, notwithstanding the appointment of the administrator, solely responsible for the affairs of the Scheme. In order for them to properly exercise this responsibility, the Administrator will inter alia: 1.1 Be a South African based company or organisation. 1.2 Comply fully with the information required in the application form for accreditation. 1.3 Ensure that none of its employees or directors serve on any Board of a scheme being administered in compliance with section 57(3) of the Act. 1.4 Ensure that records and minutes of the scheme/s
REQUIREMENTS FOR ACCREDITATION OF ADMINISTRATORS The Trustees are, notwithstanding the appointment of the administrator, solely responsible for the affairs of the Scheme. In order for them to properly exercise this responsibility, the Administrator will inter alia: 1.1 Be a South African based company or organisation. 1.2 Comply fully with the information required in the application form for accreditation. 1.3 Ensure that none of its employees or directors serve on any Board of a scheme being administered in compliance with section 57(3) of the Act. 1.4 Ensure that records and minutes of the scheme/s
Weighting score:0.2356769
ReqForAdministrators.pdf
R equirements for M edical S cheme A dministrators February 2010 1 Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, E co Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267
R equirements for M edical S cheme A dministrators February 2010 1 Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, E co Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267
Weighting score:0.2326445
Circular_38_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2247091
Unattached Operating Theatre Units 2004.pdf
Unattached Operating Theatre Units 2004 09 Sep 2004 Page 2 of 9 Version 01.11 Code Description 76 005 Local anaesthetic theatre, Per minute 6.61 (5.80) 010 General anaesthetic theatre, Per minute 20.70 (18.20) 015 Dental anaesthetic theatre (Applic able to units registered for dental procedures only), Per minute 14.00 (12.30) 061 Excimer laser theatre fee, per minute 14.80 (13.00) Ward fees (including recovery room) 019 Out-patients facility fee for ambulator y admission - chargeable for patients NOT requ iring general anaesthetic- No ward fee s applicable. Definition: Item 019 may only be used in
Unattached Operating Theatre Units 2004 09 Sep 2004 Page 2 of 9 Version 01.11 Code Description 76 005 Local anaesthetic theatre, Per minute 6.61 (5.80) 010 General anaesthetic theatre, Per minute 20.70 (18.20) 015 Dental anaesthetic theatre (Applic able to units registered for dental procedures only), Per minute 14.00 (12.30) 061 Excimer laser theatre fee, per minute 14.80 (13.00) Ward fees (including recovery room) 019 Out-patients facility fee for ambulator y admission - chargeable for patients NOT requ iring general anaesthetic- No ward fee s applicable. Definition: Item 019 may only be used in
Weighting score:0.2153869
PaediatricIntroductoryPresentation_20090922.pdf
9/22/2009 1 PMB Review Introductory remarks at Clinical Advisory Committee meetings August and September 2009 Boshoff Steenekamp REF Project Specialist Process to date PMB Review workshops early in 2008 3 drafts of a PMB review consultation document Numerous stakeholder submissions on these drafts 9/22/2009 2 Number of individuals involved Claims cost per beneficiary Few Many Low High Claims cost per beneficiary Above - threshold benefits for all PMBs Below - threshold benefits for specified services and conditions High cost events covered through PMBs (mostly in hospital) CDL and other conditions on
9/22/2009 1 PMB Review Introductory remarks at Clinical Advisory Committee meetings August and September 2009 Boshoff Steenekamp REF Project Specialist Process to date PMB Review workshops early in 2008 3 drafts of a PMB review consultation document Numerous stakeholder submissions on these drafts 9/22/2009 2 Number of individuals involved Claims cost per beneficiary Few Many Low High Claims cost per beneficiary Above - threshold benefits for all PMBs Below - threshold benefits for specified services and conditions High cost events covered through PMBs (mostly in hospital) CDL and other conditions on
Weighting score:0.2153869
MSLeviesActRegulationsDec2003.pdf
COUNCIL FOR MEDICAL SCHEMES LEVIES ACT 58 OF 2000NOTICESGNR.1440 of 8 June 2001: Imposition of levies on medical schemes DEPARTMENT OF HEALTH The Council for Medical Schemes referred to in section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000) after consultation with the Minister of Health and with the concurrence of the Minister of Finance, hereby confirms the imposition of levies on medical schemes, as set out in the Notice of Levies (No. 22029) on Medical Schemes contained in the Schedule. By order of the Council for Medical Schemes. N PADAYACHEE Chairperson: Council for Medical Schemes SCHEDULE 1. Definitions. In this notice, unless
COUNCIL FOR MEDICAL SCHEMES LEVIES ACT 58 OF 2000NOTICESGNR.1440 of 8 June 2001: Imposition of levies on medical schemes DEPARTMENT OF HEALTH The Council for Medical Schemes referred to in section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000) after consultation with the Minister of Health and with the concurrence of the Minister of Finance, hereby confirms the imposition of levies on medical schemes, as set out in the Notice of Levies (No. 22029) on Medical Schemes contained in the Schedule. By order of the Council for Medical Schemes. N PADAYACHEE Chairperson: Council for Medical Schemes SCHEDULE 1. Definitions. In this notice, unless
Weighting score:0.2131778
Circular 37 of 2008.pdf
Chairperson: Prof. William Pick Vice - Chairperson: Dr Saadiq Kariem Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) t : +27 (0)12 431 - 0500 f : +27 (0)12 430 - 7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. William Pick Vice - Chairperson: Dr Saadiq Kariem Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) t : +27 (0)12 431 - 0500 f : +27 (0)12 430 - 7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2131778
Circular12_of_ 20090609.pdf
To: Healthcare providers Medical schemes Administrators Circular 12 of 2009 Ref: Modifier code 0019 Enq: Gugulethu Tlali t : 012 431 0528 f: 012 431 0628 e: g .tlali@medicalschemes.com Date: 09 June 2009 Clarifying the use of modifier code 0019 The Council for Medical Schemes (CMS) has noted with concern an increasing number of complaints pertaining to the modifier code 0019. This Circular intends to clarify the appropriate use
To: Healthcare providers Medical schemes Administrators Circular 12 of 2009 Ref: Modifier code 0019 Enq: Gugulethu Tlali t : 012 431 0528 f: 012 431 0628 e: g .tlali@medicalschemes.com Date: 09 June 2009 Clarifying the use of modifier code 0019 The Council for Medical Schemes (CMS) has noted with concern an increasing number of complaints pertaining to the modifier code 0019. This Circular intends to clarify the appropriate use
Weighting score:0.2131778
Circular_12_of_2006_Quarterly_Returns_2006.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2131778
Circular_17_of_2007(Quarterly_returns).pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2131778
Circular_22_of_2006_Levies.pdf
TO ALL STAKEHOLDERS CIRCULAR 22 OF 2006 GENERAL NOTICE IMPOSITION OF LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 2(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 2000) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000), after consulta tion with the Minister of Health and with the concurrence of the Minister of Finance, hereby confirms the imposition of levies on medical schemes, as set out in the Notice
TO ALL STAKEHOLDERS CIRCULAR 22 OF 2006 GENERAL NOTICE IMPOSITION OF LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 2(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 2000) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000), after consulta tion with the Minister of Health and with the concurrence of the Minister of Finance, hereby confirms the imposition of levies on medical schemes, as set out in the Notice
Weighting score:0.2131778
Circular_24_of_2006_Quarterly_statutory_returns.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2131778
Circular_5_of_2006_Submission_deadline.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.2131778
Circular_5_of_2008_Levies_and_CMS_Budget_2008_2009.pdf
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COU NCIL FOR MEDI CAL SCHEMES LEVIES ACT (ACT 58 OF 2000) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000), hereby pro poses the imposition of levies on medical schemes, as set out in this Notice. The propos ed levies are due to be imposed for the purpose of meeting the general regulatory and administrative costs of the Council for Medical Schemes and the function performed by the Registrar
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COU NCIL FOR MEDI CAL SCHEMES LEVIES ACT (ACT 58 OF 2000) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 2000 (Act No. 58 of 2000), hereby pro poses the imposition of levies on medical schemes, as set out in this Notice. The propos ed levies are due to be imposed for the purpose of meeting the general regulatory and administrative costs of the Council for Medical Schemes and the function performed by the Registrar
Weighting score:0.2131778
GENERAL_NOTICE_LEVIES_ON_MEDICAL_SCHEMES_SECTION 3.pdf
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 200 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies are due to be imposed for the purpose of meeting the general regulatory and administrative costs of the Council for Medical Schemes and the function performed by the Registrar
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 200 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies are due to be imposed for the purpose of meeting the general regulatory and administrative costs of the Council for Medical Schemes and the function performed by the Registrar
Weighting score:0.2131778
LEVIES ON MEDICAL SCHEMES SECTION 3(a) 1 Nov 2011.pdf
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
Weighting score:0.2131778
Homoeopaths 2004.pdf
Homoeopaths 2004 09 Sep 2004 Page 1 of 2 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Homoeopaths 2004 09 Sep 2004 Page 1 of 2 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Weighting score:0.2131778
Homoeopaths 2006.pdf
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
Weighting score:0.2131778
CMSMarketingAnalyst2013.pdf
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest TECHNICAL MARKETING ANALYST: BENEFITS MANAGEMENT You will work in the Benefits Management unit of the Council . You will report to the Head: Benefit s Management and will be responsible for: Guidelines/Standards: Marketing of schemes and rules: Development and continuous update of the guidelines/standards for the marketing of schemes and guidelines on structure of rules of medical schemes.
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest TECHNICAL MARKETING ANALYST: BENEFITS MANAGEMENT You will work in the Benefits Management unit of the Council . You will report to the Head: Benefit s Management and will be responsible for: Guidelines/Standards: Marketing of schemes and rules: Development and continuous update of the guidelines/standards for the marketing of schemes and guidelines on structure of rules of medical schemes.
Weighting score:0.2131778
TechnicalMarketAnalyst20140414.pdf
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest. TECHNICAL MARKET ANALYST: BENEFITS MANAGEMENT You will work in the Benefits Management unit of the Council and report to the Head: Benefit s Management ; you will be responsible for: Guidelines/Standards: Marketing of schemes and rules: Developing and continuously updating the guidelines/standards for the marketing of schemes and guidelines on structure of rules of medical schemes (marketing
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest. TECHNICAL MARKET ANALYST: BENEFITS MANAGEMENT You will work in the Benefits Management unit of the Council and report to the Head: Benefit s Management ; you will be responsible for: Guidelines/Standards: Marketing of schemes and rules: Developing and continuously updating the guidelines/standards for the marketing of schemes and guidelines on structure of rules of medical schemes (marketing
Weighting score:0.2131778
AccStandardsVer5.pdf
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 5 Third party Medical Scheme Administrators Accre ditation Standards - Version 5 July 2012 1 Contents
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 5 Third party Medical Scheme Administrators Accre ditation Standards - Version 5 July 2012 1 Contents
Weighting score:0.2062173
AccStandardsVer5_10Jan2012.pdf
Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfi eld Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes
Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfi eld Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes
Weighting score:0.2062173
STDS_Ver_4_ published_19May06.pdf
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 4 Third Party Medical Scheme Administrators Accreditation Standards - Version 4 May 2006 iContents SECTION 1: INTRODUCTION........................................................................................................ ...................1 1. Executive summary.............................................................................................................. ..........................1 2. Background..................................................................................................................... ................................1 3. Accreditation methodology and supporting principles........ .................................................................... ......2 3.1. Introduction................................................................................................................... ..........................2 3.2. Severity rating................................................................................................................ .........................2 3.3. Applying for accreditation.... ................................................................................................. .................3 SECTION 2: STANDARDS DOCUMENT.................................................................................................. .......4 1. MEDICAL SCHEME ADMINISTRATORS................................................................................................4 1.1. General compliance............................................................................................................. ...........................4 1.2. System assessment.............................................................................................................. ...........................5 1.3. Member record management....................................................................................................... ...................6 1.4. Contribution management........................................................................................................ ......................7 1.5. Claims
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 4 Third Party Medical Scheme Administrators Accreditation Standards - Version 4 May 2006 iContents SECTION 1: INTRODUCTION........................................................................................................ ...................1 1. Executive summary.............................................................................................................. ..........................1 2. Background..................................................................................................................... ................................1 3. Accreditation methodology and supporting principles........ .................................................................... ......2 3.1. Introduction................................................................................................................... ..........................2 3.2. Severity rating................................................................................................................ .........................2 3.3. Applying for accreditation.... ................................................................................................. .................3 SECTION 2: STANDARDS DOCUMENT.................................................................................................. .......4 1. MEDICAL SCHEME ADMINISTRATORS................................................................................................4 1.1. General compliance............................................................................................................. ...........................4 1.2. System assessment.............................................................................................................. ...........................5 1.3. Member record management....................................................................................................... ...................6 1.4. Contribution management........................................................................................................ ......................7 1.5. Claims
Weighting score:0.2062173
STDS_Ver_4_ published_19May06.pdf
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 4 Third Party Medical Scheme Administrators Accreditation Standards - Version 4 May 2006 iContents SECTION 1: INTRODUCTION........................................................................................................ ...................1 1. Executive summary.............................................................................................................. ..........................1 2. Background..................................................................................................................... ................................1 3. Accreditation methodology and supporting principles........ .................................................................... ......2 3.1. Introduction................................................................................................................... ..........................2 3.2. Severity rating................................................................................................................ .........................2 3.3. Applying for accreditation.... ................................................................................................. .................3 SECTION 2: STANDARDS DOCUMENT.................................................................................................. .......4 1. MEDICAL SCHEME ADMINISTRATORS................................................................................................4 1.1. General compliance............................................................................................................. ...........................4 1.2. System assessment.............................................................................................................. ...........................5 1.3. Member record management....................................................................................................... ...................6 1.4. Contribution management........................................................................................................ ......................7 1.5. Claims
The Council for Medical Schemes Accreditation Standards for Third Party Administrators of Medical Schemes Standards and Measurement Criteria Version 4 Third Party Medical Scheme Administrators Accreditation Standards - Version 4 May 2006 iContents SECTION 1: INTRODUCTION........................................................................................................ ...................1 1. Executive summary.............................................................................................................. ..........................1 2. Background..................................................................................................................... ................................1 3. Accreditation methodology and supporting principles........ .................................................................... ......2 3.1. Introduction................................................................................................................... ..........................2 3.2. Severity rating................................................................................................................ .........................2 3.3. Applying for accreditation.... ................................................................................................. .................3 SECTION 2: STANDARDS DOCUMENT.................................................................................................. .......4 1. MEDICAL SCHEME ADMINISTRATORS................................................................................................4 1.1. General compliance............................................................................................................. ...........................4 1.2. System assessment.............................................................................................................. ...........................5 1.3. Member record management....................................................................................................... ...................6 1.4. Contribution management........................................................................................................ ......................7 1.5. Claims
Weighting score:0.2062173
Private Hospitals 2004.pdf
Private Hospitals 2004 09 Sep 2004 Page 2 of 17 Version 01.11 Code Description 57/58 77 001 Surgical cases: per day. R822.70 002 Thoracic and neurosurgical cases (including la minectomies and spinal fusion): per day R864.40 003 Psychiatric general ward fee, per day R681.10 004 Medical and neurological cases: per day. R822.70 005 Paediatric cases (under 14 years of age) R1015.5 0 Day admissions - all patients admitted as day patients and discharged before 23h00 on the same day 007 Day admission (irrespective of type of
Private Hospitals 2004 09 Sep 2004 Page 2 of 17 Version 01.11 Code Description 57/58 77 001 Surgical cases: per day. R822.70 002 Thoracic and neurosurgical cases (including la minectomies and spinal fusion): per day R864.40 003 Psychiatric general ward fee, per day R681.10 004 Medical and neurological cases: per day. R822.70 005 Paediatric cases (under 14 years of age) R1015.5 0 Day admissions - all patients admitted as day patients and discharged before 23h00 on the same day 007 Day admission (irrespective of type of
Weighting score:0.2062173
Act_Reg_Ammendment_20091223.pdf
3 STAATSKOERANT, 21 DESEMBER 2009 No.32823 GOVERNMENT NOTICE \001DEPARTMENT OF HEALTH No. R. 1215 21 December 2009 MEDICAL SCHEMES ACT, 1998 (ACT NO.131 OF 199B) REGULATIONS MADE IN TERMS OF THE MEDICAL SCHEMES ACT, 199B -AMENDMENT THERAPEUTIC ALGORITHMS FOR CRONIC CONDITIONS The Regulations made under the Medical Schemes Act, 1998, published under Government Notice No. R1262 of 20 October 1999, as amended by the following Government Notices: No. R 570 of 5 June 2000, No. R 650 of 30 June 2000, No. R 247 of 1 March 2002, No. R 1360 of 4 November 2003 and No. R 1402 of
3 STAATSKOERANT, 21 DESEMBER 2009 No.32823 GOVERNMENT NOTICE \001DEPARTMENT OF HEALTH No. R. 1215 21 December 2009 MEDICAL SCHEMES ACT, 1998 (ACT NO.131 OF 199B) REGULATIONS MADE IN TERMS OF THE MEDICAL SCHEMES ACT, 199B -AMENDMENT THERAPEUTIC ALGORITHMS FOR CRONIC CONDITIONS The Regulations made under the Medical Schemes Act, 1998, published under Government Notice No. R1262 of 20 October 1999, as amended by the following Government Notices: No. R 570 of 5 June 2000, No. R 650 of 30 June 2000, No. R 247 of 1 March 2002, No. R 1360 of 4 November 2003 and No. R 1402 of
Weighting score:0.2009859
AdminAgreementGuideline201207.pdf
Guideline for the preparation of administration agreements in compliance with Regulation 1 8 and the administration standards JULY 2012
Guideline for the preparation of administration agreements in compliance with Regulation 1 8 and the administration standards JULY 2012
Weighting score:0.2009859
Circular 9 2012.pdf
CIRCULAR Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
CIRCULAR Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
Weighting score:0.2009859
Circular 9 of 2012.pdf
CIRCULAR Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
CIRCULAR Chairperson: Dr RV Simelane Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
Weighting score:0.2009859
Circular19of2014.pdf
CIRCULAR Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com
CIRCULAR Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com
Weighting score:0.2009859
CodeOfConduct_20100803.pdf
Code of Conduct in respect of PMB benefits 31 July 2010 Code of Conduct in respect of PMB benefits 31 July 2010 i Contents Background and purpose ....................................... ................................................... ............................. iii Part I: The accessibility of information on access to PMB benefits, including the use of designated service providers (DSPs), requirements on marketing information, and desired educational efforts by stakeholders in respect of the PMBs ............... ..... 1 Part II: Proposed solutions to problems relating to the payment in full provisions in regulation 8 ........................................... ................................................... ..................... 4 Part III: Establishing clarity and certainty of the benefits prescribed in Annexure A
Code of Conduct in respect of PMB benefits 31 July 2010 Code of Conduct in respect of PMB benefits 31 July 2010 i Contents Background and purpose ....................................... ................................................... ............................. iii Part I: The accessibility of information on access to PMB benefits, including the use of designated service providers (DSPs), requirements on marketing information, and desired educational efforts by stakeholders in respect of the PMBs ............... ..... 1 Part II: Proposed solutions to problems relating to the payment in full provisions in regulation 8 ........................................... ................................................... ..................... 4 Part III: Establishing clarity and certainty of the benefits prescribed in Annexure A
Weighting score:0.2009859
Dental Therapy 2005.pdf
Dental Therapy 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to
Dental Therapy 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to
Weighting score:0.2009859
Dental Therapy 2005v2.06.pdf
Dental Therapy 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to
Dental Therapy 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to
Weighting score:0.2009859
Homoeopaths 2006_v04.pdf
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.2009859
Physiotherapy 2005.pdf
Physiotherapy 2005 13 Feb 2005 Page 2 of 5 Version 02.05 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : · The name and practice code number of the re ferring practitioner (where applicable). · The name of the member. · The name of the patient. · The name of the medical scheme. · The membership number of the member. · The practice code number and name of practitioner ·
Physiotherapy 2005 13 Feb 2005 Page 2 of 5 Version 02.05 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : · The name and practice code number of the re ferring practitioner (where applicable). · The name of the member. · The name of the patient. · The name of the medical scheme. · The membership number of the member. · The practice code number and name of practitioner ·
Weighting score:0.2009859
Physiotherapy 2005v2.06.pdf
Physiotherapy 2005 13 Feb 2005 Page 2 of 5 Version 02.05 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : · The name and practice code number of the re ferring practitioner (where applicable). · The name of the member. · The name of the patient. · The name of the medical scheme. · The membership number of the member. · The practice code number and name of practitioner ·
Physiotherapy 2005 13 Feb 2005 Page 2 of 5 Version 02.05 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : · The name and practice code number of the re ferring practitioner (where applicable). · The name of the member. · The name of the patient. · The name of the medical scheme. · The membership number of the member. · The practice code number and name of practitioner ·
Weighting score:0.2009859
Physiotherapy 2006.pdf
Physiotherapy 2006 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : \267 The name and practice code number of the re ferring practitioner (where applicable). \267 The name of the member. \267 The name of the patient. \267 The name of the medical scheme. \267 The membership number of the member. \267 The practice code number and name of
Physiotherapy 2006 011 Every physiotherapist must acquaint himself with the prov isions of the Medical Schemes Act, 1998 and the regulations promulgated under the Act in connection with the rendering of accounts. Every account shall contain the following particulars : \267 The name and practice code number of the re ferring practitioner (where applicable). \267 The name of the member. \267 The name of the patient. \267 The name of the medical scheme. \267 The membership number of the member. \267 The practice code number and name of
Weighting score:0.2009859
ModelrulesfinalrevisedFeb2004.pdf
1 MODEL RULES FOR MEDICAL SCHEMES REGISTERED UNDER THE MEDICAL SCHEMES ACT, 1998 (ACT NO. 131 OF 1998) RULE TABLE OF CONTENTS PAGE 1 NAME 2 2 LEGAL PERSONA 2 3 REGISTERED OFFICE 2 4 DEFINITIONS 2 5 OBJECTS 6 6 MEMBERSHIP 7 7 REGISTRATION AND DE-REGISTRATION OF DEPENDANTS 8 8 TERMS AND CONDITIONS APPLICABLE TO MEMBERSHIP 8 9 TRANSFER OF EMPLOYER GROUPS FROM ANOTHER MEDICAL SCHEME 11 10 MEMBERSHIP CARD AND CERTIFICATE OF MEMBERSHIP 11 11 CHANGE OF ADDRESS OF MEMBER 11 12 TERMINATION OF MEMBERSHIP
1 MODEL RULES FOR MEDICAL SCHEMES REGISTERED UNDER THE MEDICAL SCHEMES ACT, 1998 (ACT NO. 131 OF 1998) RULE TABLE OF CONTENTS PAGE 1 NAME 2 2 LEGAL PERSONA 2 3 REGISTERED OFFICE 2 4 DEFINITIONS 2 5 OBJECTS 6 6 MEMBERSHIP 7 7 REGISTRATION AND DE-REGISTRATION OF DEPENDANTS 8 8 TERMS AND CONDITIONS APPLICABLE TO MEMBERSHIP 8 9 TRANSFER OF EMPLOYER GROUPS FROM ANOTHER MEDICAL SCHEME 11 10 MEMBERSHIP CARD AND CERTIFICATE OF MEMBERSHIP 11 11 CHANGE OF ADDRESS OF MEMBER 11 12 TERMINATION OF MEMBERSHIP
Weighting score:0.1994095
AuditorApprovalQuestionnaire_20090918.pdf
Auditor Approval Questionnaire Information required by the Registrar of Medical Schemes in considering the approval of the appointment/reappointment of an auditor of a medical scheme Instructions for completion of the questionnaire The form consists of four parts: Part A Appointment by scheme Part B Applicable to the audit firm Part C A pplicable to the Scheme completed by the engagement partner who
Auditor Approval Questionnaire Information required by the Registrar of Medical Schemes in considering the approval of the appointment/reappointment of an auditor of a medical scheme Instructions for completion of the questionnaire The form consists of four parts: Part A Appointment by scheme Part B Applicable to the audit firm Part C A pplicable to the Scheme completed by the engagement partner who
Weighting score:0.1986167
Standard doc managed care final 22 Oct 03.pdf
Accreditation standards for managed care organisations Standards and measurement criteria Council for Medical Schemes 1 1. Introduction: 1.1. Managed care, within the South African co ntext,
Accreditation standards for managed care organisations Standards and measurement criteria Council for Medical Schemes 1 1. Introduction: 1.1. Managed care, within the South African co ntext,
Weighting score:0.1986167
Addendum B Patholog Notes.pdf
549 (a) that is specified rendered by or on behalf of an Approved Pathology Provider for a person who is a patient of that Approved Pathology Provider who has determined that the service is necessary; or (b) that is specified in only one of immunohistochemistry items 72846, 72847 or 72848 or immunocytochemistry items 73059, 73060 or 73061 or electro nmicroscopy items 72851 or 72852 and is consid ered necessary by the Approved Pathology Provider as a consequence of information resulting from a pathology service contained in tissue examination items 72813 - 72836, cytology items 73045 - 73051 or tissue examination
549 (a) that is specified rendered by or on behalf of an Approved Pathology Provider for a person who is a patient of that Approved Pathology Provider who has determined that the service is necessary; or (b) that is specified in only one of immunohistochemistry items 72846, 72847 or 72848 or immunocytochemistry items 73059, 73060 or 73061 or electro nmicroscopy items 72851 or 72852 and is consid ered necessary by the Approved Pathology Provider as a consequence of information resulting from a pathology service contained in tissue examination items 72813 - 72836, cytology items 73045 - 73051 or tissue examination
Weighting score:0.1966205
Requirements_for_accreditation_of_3rdparty_admins.pdf
Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Council for Medical Schemes Accreditation Standar ds for Third Party Administrators of Medical Schemes Standards and Meas urement Criteria Version 3 Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Contents 1 EXECUTIVE SUMMARY.............................................................................................................. .....................................................1 2 OBJECTIVES..................................................................................................................... ....................................................................1 3 ACCREDITATION METHODOLOGY AND SUPPORTING PRINCIPLES............................................................................ ..2 3.1 INTRODUCTION............................................................................................................................... ..................................................2 3.2 SEVERITY............................................................................................................................... ...........................................................2 3.3 APPLYING FOR ACCREDITATION............................................................................................................................... ........................4 STANDARDS DOCUMENT............................................................................................................. ...........................................................5 INTRODUCTION............................................................................................................................... ...............................................................5 1 MEDICAL SCHEME ADMINISTRATORS.................................................................................................. ...................................6 1.1
Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Council for Medical Schemes Accreditation Standar ds for Third Party Administrators of Medical Schemes Standards and Meas urement Criteria Version 3 Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Contents 1 EXECUTIVE SUMMARY.............................................................................................................. .....................................................1 2 OBJECTIVES..................................................................................................................... ....................................................................1 3 ACCREDITATION METHODOLOGY AND SUPPORTING PRINCIPLES............................................................................ ..2 3.1 INTRODUCTION............................................................................................................................... ..................................................2 3.2 SEVERITY............................................................................................................................... ...........................................................2 3.3 APPLYING FOR ACCREDITATION............................................................................................................................... ........................4 STANDARDS DOCUMENT............................................................................................................. ...........................................................5 INTRODUCTION............................................................................................................................... ...............................................................5 1 MEDICAL SCHEME ADMINISTRATORS.................................................................................................. ...................................6 1.1
Weighting score:0.1865305
Requirements_for_accreditation_of_3rdparty_admins.pdf
Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Council for Medical Schemes Accreditation Standar ds for Third Party Administrators of Medical Schemes Standards and Meas urement Criteria Version 3 Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Contents 1 EXECUTIVE SUMMARY.............................................................................................................. .....................................................1 2 OBJECTIVES..................................................................................................................... ....................................................................1 3 ACCREDITATION METHODOLOGY AND SUPPORTING PRINCIPLES............................................................................ ..2 3.1 INTRODUCTION............................................................................................................................... ..................................................2 3.2 SEVERITY............................................................................................................................... ...........................................................2 3.3 APPLYING FOR ACCREDITATION............................................................................................................................... ........................4 STANDARDS DOCUMENT............................................................................................................. ...........................................................5 INTRODUCTION............................................................................................................................... ...............................................................5 1 MEDICAL SCHEME ADMINISTRATORS.................................................................................................. ...................................6 1.1
Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Council for Medical Schemes Accreditation Standar ds for Third Party Administrators of Medical Schemes Standards and Meas urement Criteria Version 3 Council for Medical Schemes Accreditation Standards for Administrators Version 3 - 12 December 2003 Contents 1 EXECUTIVE SUMMARY.............................................................................................................. .....................................................1 2 OBJECTIVES..................................................................................................................... ....................................................................1 3 ACCREDITATION METHODOLOGY AND SUPPORTING PRINCIPLES............................................................................ ..2 3.1 INTRODUCTION............................................................................................................................... ..................................................2 3.2 SEVERITY............................................................................................................................... ...........................................................2 3.3 APPLYING FOR ACCREDITATION............................................................................................................................... ........................4 STANDARDS DOCUMENT............................................................................................................. ...........................................................5 INTRODUCTION............................................................................................................................... ...............................................................5 1 MEDICAL SCHEME ADMINISTRATORS.................................................................................................. ...................................6 1.1
Weighting score:0.1865305
Circular_21_2002.pdf
MODEL RULES FOR MEDICAL SCHEMES REGISTERED UNDER THE MEDICAL SCHEMES ACT, 1998 (ACT NO. 131 OF 1998) RULE TABLE OF CONTENTS PAGE 1 NAME 3 2 LEGAL PERSONA 3 3 REGISTERED OFFICE 3 4 DEFINITIONS 3 5 OBJECTS 7 6 MEMBERSHIP 7 7 REGISTRATION AND DE-REGISTRATION OF DEPENDANTS 10 8 TERMS AND CONDITIONS APPLICABLE TO MEMBERSHIP 11 9 TRANSFER OF EMPLOYER GROUPS FROM ANOTHER MEDICAL SCHEME 13 10 MEMBERSHIP CARD AND CERTIFICATE OF MEMBERSHIP 13 11 CHANGE OF ADDRESS OF MEMBER 13 12 TERMINATION OF MEMBERSHIP 14 13 CONTRIBUTIONS 15 14 LIABILITIES OF EMPLOYER
MODEL RULES FOR MEDICAL SCHEMES REGISTERED UNDER THE MEDICAL SCHEMES ACT, 1998 (ACT NO. 131 OF 1998) RULE TABLE OF CONTENTS PAGE 1 NAME 3 2 LEGAL PERSONA 3 3 REGISTERED OFFICE 3 4 DEFINITIONS 3 5 OBJECTS 7 6 MEMBERSHIP 7 7 REGISTRATION AND DE-REGISTRATION OF DEPENDANTS 10 8 TERMS AND CONDITIONS APPLICABLE TO MEMBERSHIP 11 9 TRANSFER OF EMPLOYER GROUPS FROM ANOTHER MEDICAL SCHEME 13 10 MEMBERSHIP CARD AND CERTIFICATE OF MEMBERSHIP 13 11 CHANGE OF ADDRESS OF MEMBER 13 12 TERMINATION OF MEMBERSHIP 14 13 CONTRIBUTIONS 15 14 LIABILITIES OF EMPLOYER
Weighting score:0.1846174
Circular_25_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1846174
Circular_51_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1846174
DiscusDocComGuid.pdf
Communication Guidelines for Medical Schemes Discussion Document Comments on the document should reach the CMS by no later than Monday, 2 July 2012 . Kindly note that all submi ssions must be forwarded to the dedicated e - mail
Communication Guidelines for Medical Schemes Discussion Document Comments on the document should reach the CMS by no later than Monday, 2 July 2012 . Kindly note that all submi ssions must be forwarded to the dedicated e - mail
Weighting score:0.1846174
CommGdlns20140708.pdf
Communication Guidelines for Medical Schemes Document Enquiries must be forwarded to the dedicated e - mail addresses or fax addresses reflected below: Contact : Daisy Seakgoe / Wayne Davids Facsimile
Communication Guidelines for Medical Schemes Document Enquiries must be forwarded to the dedicated e - mail addresses or fax addresses reflected below: Contact : Daisy Seakgoe / Wayne Davids Facsimile
Weighting score:0.1846174
Dental Practitioners 2004.pdf
Dental Practitioners 2004 09 Sep 2004 Page 2 of 51 Version 01.11 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be billed. Use Modifier 8011 with a narrative de scription. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioners election. Under the se circumstances a lower fee may be billed. The service provided can be identified by its usual
Dental Practitioners 2004 09 Sep 2004 Page 2 of 51 Version 01.11 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be billed. Use Modifier 8011 with a narrative de scription. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioners election. Under the se circumstances a lower fee may be billed. The service provided can be identified by its usual
Weighting score:0.1831155
Private Hospitals 2005.pdf
Private Hospitals 2005 13 Feb 2005 Page 2 of 43 Version 02.05 H All accounts shall be accompanied by a copy of the relevant t heatre accounts specifying all details of items charged, as well as all the procedures performed. Photocopies of all other documents pertaining to the patients account must be provided on r equest. Medical schemes shall have the right to inspect the o riginal source documents at the hospital/unattached operating theatre unit concerned. C I All accounts containing items which are s ubject to a discount in terms of the recommended benefit shall indicate such items i ndividually and shall
Private Hospitals 2005 13 Feb 2005 Page 2 of 43 Version 02.05 H All accounts shall be accompanied by a copy of the relevant t heatre accounts specifying all details of items charged, as well as all the procedures performed. Photocopies of all other documents pertaining to the patients account must be provided on r equest. Medical schemes shall have the right to inspect the o riginal source documents at the hospital/unattached operating theatre unit concerned. C I All accounts containing items which are s ubject to a discount in terms of the recommended benefit shall indicate such items i ndividually and shall
Weighting score:0.1831155
Private Hospitals 2005v2.06.pdf
Private Hospitals 2005 13 Feb 2005 Page 2 of 43 Version 02.05 H All accounts shall be accompanied by a copy of the relevant t heatre accounts specifying all details of items charged, as well as all the procedures performed. Photocopies of all other documents pertaining to the patients account must be provided on r equest. Medical schemes shall have the right to inspect the o riginal source documents at the hospital/unattached operating theatre unit concerned. C I All accounts containing items which are s ubject to a discount in terms of the recommended benefit shall indicate such items i ndividually and shall
Private Hospitals 2005 13 Feb 2005 Page 2 of 43 Version 02.05 H All accounts shall be accompanied by a copy of the relevant t heatre accounts specifying all details of items charged, as well as all the procedures performed. Photocopies of all other documents pertaining to the patients account must be provided on r equest. Medical schemes shall have the right to inspect the o riginal source documents at the hospital/unattached operating theatre unit concerned. C I All accounts containing items which are s ubject to a discount in terms of the recommended benefit shall indicate such items i ndividually and shall
Weighting score:0.1831155
MSLeviesActDec2003.pdf
COUNCIL FOR MEDICAL SCHEMES LEVIES ACT NO. 58 OF 2000[ASSENTED TO 5 DECEMBER, 2000] [DATE OF COMMENCEMENT: 1 FEBRUARY, 2001] ( English text signed by the President ) ACT To provide for the imposition of levies by the Council for Medical Schemes; and to provide for matters incidental thereto. BE IT ENACTED by the Parliament of the Republic of South Africa, as follows: ARRANGEMENT OF SECTIONS 1.Definitions 2.Imposition of levies 3.Distribution of levies 4.Non-payment of levies 5.Levy imposition to lapse after five years 6.Assessment of performance of Council for Medical Schemes 7.Short title and commencement 1. Definitions. In this Act, unless inconsistent with the context Council means the Council for Medical Schemes established by section 3 (1)
COUNCIL FOR MEDICAL SCHEMES LEVIES ACT NO. 58 OF 2000[ASSENTED TO 5 DECEMBER, 2000] [DATE OF COMMENCEMENT: 1 FEBRUARY, 2001] ( English text signed by the President ) ACT To provide for the imposition of levies by the Council for Medical Schemes; and to provide for matters incidental thereto. BE IT ENACTED by the Parliament of the Republic of South Africa, as follows: ARRANGEMENT OF SECTIONS 1.Definitions 2.Imposition of levies 3.Distribution of levies 4.Non-payment of levies 5.Levy imposition to lapse after five years 6.Assessment of performance of Council for Medical Schemes 7.Short title and commencement 1. Definitions. In this Act, unless inconsistent with the context Council means the Council for Medical Schemes established by section 3 (1)
Weighting score:0.1776481
Request form for access to information.pdf
REQUEST FOR ACCESS TO RE CORDS OF PUBLIC BODY Section 18[1] of the Prom otion of Access to Informa tion Act [Act 2 of 2000] FOR OFFICE USE ONLY Reference number. Request received by On at
REQUEST FOR ACCESS TO RE CORDS OF PUBLIC BODY Section 18[1] of the Prom otion of Access to Informa tion Act [Act 2 of 2000] FOR OFFICE USE ONLY Reference number. Request received by On at
Weighting score:0.1776481
Circular_28_of_2006.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1776481
Circular_58_of_2005_2006_03_new_schedules.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1776481
CMScript_Nov08.pdf
Pictures: courtesy of www.flickr.com and Microsoft online clip art November 2008 Join forces against HIV with your medical scheme HIV is a PMB. No, this is not a rap songs lyrics; however, these acronyms are sure to put a bounce in your step when you see what they can do for your health and your pocket. HIV/Aids is a disease that strikes fear in peoples hearts. The one important message to get across, however, is that a positive test result is not a death sentence. Medical schemes are increasingly geared towards giving people living with HIV/Aids that much needed extra bit of support for a healthy and productive life. Most medical schemes in South Africa make specific provision for the treatment of HIV provided that members declare their status. As with any other medical condition, your scheme can only make the benefits available to you if they know that you are suffering from the particular disease. However, the stigma associated with HIV/Aids in our society makes it very difficult for people to disclose their status and seek help. According to the Council for Medical Schemes, scheme members privacy is protected by the Medical Schemes Act. The scheme and its contracted parties, such as doctors and pharmacies, may not share any information about a beneficiary with anybody else, be they employers, spouses or even the main member. All clinical information, including a persons HIV status, has to be treated as confidential. But what about the medical scheme statements that are sent to the main member dont they reveal what a person was treated for? Definitely not, says the Council spokesperson. The statement only lists the service provider(s) involved, such as the GP, specialist or pharmacy, and in some cases the medication prescribed. Unless someone goes to great lengths to find out what a particular drug is for, the patients illness remains between her and the service provider. A ll the clinical and private information necessary to participate in disease management programmes has to be treated as confidential by the operators (medical scheme or managed care organisation) of the programme. By disclosing your HIV status to your medical scheme, you might qualify for more benefits than when you seek treatment for the individual symptoms or opportunistic infections associated with HIV/Aids . The benefits of managed care As with other chronic conditions, such as diabetes and hypertension, your medical scheme could require that you join a disease management programme. These programmes aim to improve the health of members by helping them to monitor and manage their illness, providing them with information and education and, very importantly, lending them moral support. Apart from the standard PMB related benefits, HIV/Aids disease management programmes also provide members with access to: a network of professionals for pre and post testing counselling ; a network of doctors and specialists who are experts in the management and treatment of HIV/Aids; specific interventions at specific intervals, such as pathology tests, necessary to monitor both the treatment and progress o f the disease; reminders to go for tests and consultations; a network of hospitals for the treatment of HIV/Aids related illnesses; anti retroviral therapy and other treatments for, for example, opportunistic infections, according to the schemes formulary. The programme might make use of DSP pharmacies or courier pharmacies for participants in remote areas; and HIV/Aids specific call centres, mostly operated by registered nurses, for assistance with benefit queries, disease education and any additional information regarding aspects of the disease such as diagnosis, treatment side effects, caregiver support etc. A significant advantage is that your scheme will ensure that the above mentioned services are paid for from the correct benefit limits as long as you participate in the programme. In this way, no claims will be paid from your savings account and your HIV related expenses will be covered if your other benefit limits have been exhausted. support@medicalschemes.com Tel: 012 431-0500 / 0861 123 267 Fax: 012 430-7644 Mail: Private
Pictures: courtesy of www.flickr.com and Microsoft online clip art November 2008 Join forces against HIV with your medical scheme HIV is a PMB. No, this is not a rap songs lyrics; however, these acronyms are sure to put a bounce in your step when you see what they can do for your health and your pocket. HIV/Aids is a disease that strikes fear in peoples hearts. The one important message to get across, however, is that a positive test result is not a death sentence. Medical schemes are increasingly geared towards giving people living with HIV/Aids that much needed extra bit of support for a healthy and productive life. Most medical schemes in South Africa make specific provision for the treatment of HIV provided that members declare their status. As with any other medical condition, your scheme can only make the benefits available to you if they know that you are suffering from the particular disease. However, the stigma associated with HIV/Aids in our society makes it very difficult for people to disclose their status and seek help. According to the Council for Medical Schemes, scheme members privacy is protected by the Medical Schemes Act. The scheme and its contracted parties, such as doctors and pharmacies, may not share any information about a beneficiary with anybody else, be they employers, spouses or even the main member. All clinical information, including a persons HIV status, has to be treated as confidential. But what about the medical scheme statements that are sent to the main member dont they reveal what a person was treated for? Definitely not, says the Council spokesperson. The statement only lists the service provider(s) involved, such as the GP, specialist or pharmacy, and in some cases the medication prescribed. Unless someone goes to great lengths to find out what a particular drug is for, the patients illness remains between her and the service provider. A ll the clinical and private information necessary to participate in disease management programmes has to be treated as confidential by the operators (medical scheme or managed care organisation) of the programme. By disclosing your HIV status to your medical scheme, you might qualify for more benefits than when you seek treatment for the individual symptoms or opportunistic infections associated with HIV/Aids . The benefits of managed care As with other chronic conditions, such as diabetes and hypertension, your medical scheme could require that you join a disease management programme. These programmes aim to improve the health of members by helping them to monitor and manage their illness, providing them with information and education and, very importantly, lending them moral support. Apart from the standard PMB related benefits, HIV/Aids disease management programmes also provide members with access to: a network of professionals for pre and post testing counselling ; a network of doctors and specialists who are experts in the management and treatment of HIV/Aids; specific interventions at specific intervals, such as pathology tests, necessary to monitor both the treatment and progress o f the disease; reminders to go for tests and consultations; a network of hospitals for the treatment of HIV/Aids related illnesses; anti retroviral therapy and other treatments for, for example, opportunistic infections, according to the schemes formulary. The programme might make use of DSP pharmacies or courier pharmacies for participants in remote areas; and HIV/Aids specific call centres, mostly operated by registered nurses, for assistance with benefit queries, disease education and any additional information regarding aspects of the disease such as diagnosis, treatment side effects, caregiver support etc. A significant advantage is that your scheme will ensure that the above mentioned services are paid for from the correct benefit limits as long as you participate in the programme. In this way, no claims will be paid from your savings account and your HIV related expenses will be covered if your other benefit limits have been exhausted. support@medicalschemes.com Tel: 012 431-0500 / 0861 123 267 Fax: 012 430-7644 Mail: Private
Weighting score:0.1776481
20131127MSABPresentation.pdf
Feedback on the Medical Schemes Amendment Bill 27 November 2013 Presented by Alicia Schoeman CMS Indaba Contents 1.Development of the MSAB 2.Legislative drafting principles 3.Key structural changes 4.Incidental/other changes DEVELOPMENT OF THE MEDICAL SCHEMES AMENDMENT BILL Preparation of a Draft Bill by a government department under the guidance of the Minister External legal review Minister introduces Bill in DOH Approval of final version The way forward The way forward SMM and Business Units finalized amendments 29 November 2012 Approval of Bill by Full Council Final version submitted to the Minister in October 2013 2004 : Workshop, process stalled 2008-2010 : Drafted a Bill internally 2011 : Workshop with
Feedback on the Medical Schemes Amendment Bill 27 November 2013 Presented by Alicia Schoeman CMS Indaba Contents 1.Development of the MSAB 2.Legislative drafting principles 3.Key structural changes 4.Incidental/other changes DEVELOPMENT OF THE MEDICAL SCHEMES AMENDMENT BILL Preparation of a Draft Bill by a government department under the guidance of the Minister External legal review Minister introduces Bill in DOH Approval of final version The way forward The way forward SMM and Business Units finalized amendments 29 November 2012 Approval of Bill by Full Council Final version submitted to the Minister in October 2013 2004 : Workshop, process stalled 2008-2010 : Drafted a Bill internally 2011 : Workshop with
Weighting score:0.1776481
AdminstratorAgreementGuideline.pdf
Guideline for the preparation of administration agreements in compliance with Regulation 1 8 and the administration standards September 2011
Guideline for the preparation of administration agreements in compliance with Regulation 1 8 and the administration standards September 2011
Weighting score:0.1776481
PMBDefProject_TOR.pdf
TERMS OF REFERENCE: PRESCRIBED MINIMUM BENEFIT ( PMB ) DEFINITION PROJECT 06 October 2010 Contents I. Background ................................ ................................ ................................ ................................ ..... 2 II. The process ................................ ................................ ................................ ................................ ..... 3 III. Composition of Clinical Advisory committees (CACs) ................................ ................................ .... 3 IV. Criteria guiding the development of PMB definitions
TERMS OF REFERENCE: PRESCRIBED MINIMUM BENEFIT ( PMB ) DEFINITION PROJECT 06 October 2010 Contents I. Background ................................ ................................ ................................ ................................ ..... 2 II. The process ................................ ................................ ................................ ................................ ..... 3 III. Composition of Clinical Advisory committees (CACs) ................................ ................................ .... 3 IV. Criteria guiding the development of PMB definitions
Weighting score:0.1776481
Homoeopaths 2006pluscpix.pdf
Homoeopaths 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Homoeopaths 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Homoeopaths 2006_v05.pdf
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Homoeopaths 2006_v06.pdf
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Homoeopaths 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY HOMOEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Nursing Agencies 2004.pdf
Nursing Agencies 2004 09 Sep 2004 Page 1 of 6 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSING AGENCIES AND ACCREDITED HOME HEALTHCARE PROVIDERS AS AN ALTERNATIVE TO HOSPITALISAT ION, WITH AN 80 PRACTICE NUMBER EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example,
Nursing Agencies 2004 09 Sep 2004 Page 1 of 6 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY REGISTERED NURSING AGENCIES AND ACCREDITED HOME HEALTHCARE PROVIDERS AS AN ALTERNATIVE TO HOSPITALISAT ION, WITH AN 80 PRACTICE NUMBER EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example,
Weighting score:0.1776481
Osteopathy 2006.pdf
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
Weighting score:0.1776481
Osteopathy 2006pluscpix.pdf
Osteopathy 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Osteopathy 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Osteopathy 2006_v04.pdf
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Osteopathy 2006_v05.pdf
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Osteopathy 2006_v06.pdf
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Osteopathy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY OSTEOPATHS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1776481
Social Workers 2004.pdf
Social Workers 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SOCIAL WORKERS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular
Social Workers 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SOCIAL WORKERS, EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular
Weighting score:0.1776481
PMBDefProject_TOR.pdf
TERMS OF REFERENCE: PRESCRIBED MINIMUM BENEFIT ( PMB ) DEFINITION PROJECT 06 October 2010 Contents I. Background ................................ ................................ ................................ ................................ ..... 2 II. The process ................................ ................................ ................................ ................................ ..... 3 III. Composition of Clinical Advisory committees (CACs) ................................ ................................ .... 3 IV. Criteria guiding the development of PMB definitions
TERMS OF REFERENCE: PRESCRIBED MINIMUM BENEFIT ( PMB ) DEFINITION PROJECT 06 October 2010 Contents I. Background ................................ ................................ ................................ ................................ ..... 2 II. The process ................................ ................................ ................................ ................................ ..... 3 III. Composition of Clinical Advisory committees (CACs) ................................ ................................ .... 3 IV. Criteria guiding the development of PMB definitions
Weighting score:0.1776481
SRPETCO.pdf
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following positions exist for the person driven by a desire to protect the public interest. EDUCATION & TRAINING MANAGER COMMUNICATION OFFICER You will work within the Stakeholder Relations unit of the Council and will report to Head: Stakeholder Relations. You will be responsible for the following: Training Administration Revise and update
The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following positions exist for the person driven by a desire to protect the public interest. EDUCATION & TRAINING MANAGER COMMUNICATION OFFICER You will work within the Stakeholder Relations unit of the Council and will report to Head: Stakeholder Relations. You will be responsible for the following: Training Administration Revise and update
Weighting score:0.1776481
Vacancies_March_2006.pdf
The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to regulate medical schemes. We have the following 3 years contract positions for persons driven by protecting the public interest. SENIOR FINANCIAL ANALYST SENIOR ACCREDITATION ANALYST You will work within a team of CAs and other Financial Analysts and will be responsible for: Analyzing of annual financial statements, financial returns, management accounts and business plans in order to assess the true financial position
The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to regulate medical schemes. We have the following 3 years contract positions for persons driven by protecting the public interest. SENIOR FINANCIAL ANALYST SENIOR ACCREDITATION ANALYST You will work within a team of CAs and other Financial Analysts and will be responsible for: Analyzing of annual financial statements, financial returns, management accounts and business plans in order to assess the true financial position
Weighting score:0.1776481
Office of the CFO/Internal Finance
The Office of the Chief Financial Officer and Internal Finance serves all the business units in CMS, the senior management team and Council by maintaining an efficient, effective and transparent system of financial management that complies with the applicable legislation. They also serve the Audit Committee, Internal Auditors, National Department of Health, National Treasury and Auditor-General by making available to them information and reports that allow them to carry out their statutory responsibilities. By doing this, we help Council to be a reputable Regulator.Our Chief Financial Officer is Mr. Daniel Lehutjo. This Unit provides support to the strategic aims of
The Office of the Chief Financial Officer and Internal Finance serves all the business units in CMS, the senior management team and Council by maintaining an efficient, effective and transparent system of financial management that complies with the applicable legislation. They also serve the Audit Committee, Internal Auditors, National Department of Health, National Treasury and Auditor-General by making available to them information and reports that allow them to carry out their statutory responsibilities. By doing this, we help Council to be a reputable Regulator.Our Chief Financial Officer is Mr. Daniel Lehutjo. This Unit provides support to the strategic aims of
Weighting score:0.1776481
Circular_41_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1758627
AuditorQuestionnaire_HelpFile.pdf
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE 2013 HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 16 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ......................................3 HOW SHOULD YOU REGISTER .........................................................................4 Login onto auditor questionnaire ............................................................4 Registration ..............................................................................................5 Forgot your password? ............................................................................6 Contact us .................................................................................................7 COMPLETING THE AUDITOR QUESTIONNAIRE
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE 2013 HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 16 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ......................................3 HOW SHOULD YOU REGISTER .........................................................................4 Login onto auditor questionnaire ............................................................4 Registration ..............................................................................................5 Forgot your password? ............................................................................6 Contact us .................................................................................................7 COMPLETING THE AUDITOR QUESTIONNAIRE
Weighting score:0.1758627
SMMHCSlIndct.pdf
Selection of Indicators high level guidance Dr Selaelo Mametja Defining Quality of Care The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge or guidelines within the given resource setting. As compelling as that definition is, it does not provide much guidance to a researcher interested in developing a measure or set of measures. A subsequent IOM report specified seven aims of a high quality medical care system that are more specific Seven Aims
Selection of Indicators high level guidance Dr Selaelo Mametja Defining Quality of Care The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge or guidelines within the given resource setting. As compelling as that definition is, it does not provide much guidance to a researcher interested in developing a measure or set of measures. A subsequent IOM report specified seven aims of a high quality medical care system that are more specific Seven Aims
Weighting score:0.1758627
Circular_20_of_2006_Admin_Standards.pdf
ACCREDITATION OF THIRD PARTY MEDICAL SCHEME ADMINISTRATORS CHANGES TO VERSION 3, INCLUDED IN VERSION 4 Standard ref - Version 3 Standard ref - Version 4 Standard description, V3 Standard description, V4 Comments 1.1 General compliance 1.1.2 Standard : The administrator has in place administration agreements, in compliance with the provisions of Regulations 18 and 19 of the Act, for all schemes under its administration. 1.1.2.1 1.1.2.1 Administration agreements exist for all medical schemes for whom administration services are
ACCREDITATION OF THIRD PARTY MEDICAL SCHEME ADMINISTRATORS CHANGES TO VERSION 3, INCLUDED IN VERSION 4 Standard ref - Version 3 Standard ref - Version 4 Standard description, V3 Standard description, V4 Comments 1.1 General compliance 1.1.2 Standard : The administrator has in place administration agreements, in compliance with the provisions of Regulations 18 and 19 of the Act, for all schemes under its administration. 1.1.2.1 1.1.2.1 Administration agreements exist for all medical schemes for whom administration services are
Weighting score:0.1720071
Private Hospitals 2006_v05.pdf
Private Hospitals 2006 20 Dec 2005 Page 3 of 36 Version 2006.05 Maternity 1. The maternity fees are a fixed per di em fee and replace all other charges: INCLUDING: Charges such as multiple births (nursery fee for 2nd baby excluded); After-hour deliveries (including caesareans); Labour ward or other ward fees, nursery fees; Incubators; Phototherapy; Theatre and equipment fees; and Surgical items (see list under point 8). But EXCLUDE Sections 5.1 to 5.3; Sections 5.7 to 5.8 (Gases); and 1. The costs of special treatment of newly born infants, e.g.
Private Hospitals 2006 20 Dec 2005 Page 3 of 36 Version 2006.05 Maternity 1. The maternity fees are a fixed per di em fee and replace all other charges: INCLUDING: Charges such as multiple births (nursery fee for 2nd baby excluded); After-hour deliveries (including caesareans); Labour ward or other ward fees, nursery fees; Incubators; Phototherapy; Theatre and equipment fees; and Surgical items (see list under point 8). But EXCLUDE Sections 5.1 to 5.3; Sections 5.7 to 5.8 (Gases); and 1. The costs of special treatment of newly born infants, e.g.
Weighting score:0.1720071
Private Hospitals 2006_v06.pdf
Private Hospitals 2006 04 Feb 2006 Page 3 of 36 Version 2006.06 Maternity 1. The maternity fees are a fixed per di em fee and replace all other charges: INCLUDING: Charges such as multiple births (nursery fee for 2nd baby excluded); After-hour deliveries (including caesareans); Labour ward or other ward fees, nursery fees; Incubators; Phototherapy; Theatre and equipment fees; and Surgical items (see list under point 8). But EXCLUDE Sections 5.1 to 5.3; Sections 5.7 to 5.8 (Gases); and 1. The costs of special treatment of newly born infants, e.g.
Private Hospitals 2006 04 Feb 2006 Page 3 of 36 Version 2006.06 Maternity 1. The maternity fees are a fixed per di em fee and replace all other charges: INCLUDING: Charges such as multiple births (nursery fee for 2nd baby excluded); After-hour deliveries (including caesareans); Labour ward or other ward fees, nursery fees; Incubators; Phototherapy; Theatre and equipment fees; and Surgical items (see list under point 8). But EXCLUDE Sections 5.1 to 5.3; Sections 5.7 to 5.8 (Gases); and 1. The costs of special treatment of newly born infants, e.g.
Weighting score:0.1720071
Dental Practitioners 2006pluscpix.pdf
Code Description Ver General Dental Practice Maxillo- facial and Oral Surgery Orthodontic s Oral Medicine and Periodontics Prosthodont ics Oral Pathology M P Lab T C 18 Dec 2006 Page 2 of 54 Version 2007.03 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the
Code Description Ver General Dental Practice Maxillo- facial and Oral Surgery Orthodontic s Oral Medicine and Periodontics Prosthodont ics Oral Pathology M P Lab T C 18 Dec 2006 Page 2 of 54 Version 2007.03 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the
Weighting score:0.1661746
Private Hospitals 2006.pdf
Private Hospitals 2006 14 Aug 2005 Page 2 of 43 Version 2006.02 1 ACCOMMODATION Ward fees Hospitals and unattached operating theatre units shall indicate the exact time of admission and discharge on all accounts. In the case of hospitals, the day admission fee (code 007) sha ll be charged in respect of all patients admitted as day patients and discharged before 23h00 on the same date. The following will be applicable to items 001 to 005, 015, 020, 200, 201, 202 and 215 to 218: On the day of admission: If
Private Hospitals 2006 14 Aug 2005 Page 2 of 43 Version 2006.02 1 ACCOMMODATION Ward fees Hospitals and unattached operating theatre units shall indicate the exact time of admission and discharge on all accounts. In the case of hospitals, the day admission fee (code 007) sha ll be charged in respect of all patients admitted as day patients and discharged before 23h00 on the same date. The following will be applicable to items 001 to 005, 015, 020, 200, 201, 202 and 215 to 218: On the day of admission: If
Weighting score:0.1661746
Identification_Of_Beneficiaries_with_REF_Risk_Factors.pdf
Guidelines for the Identification of Beneficiaries with REF Risk Factors in Accordance with the REF Entry and Verification Criteria Version 1 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 22 November 2005 Applicable before 1 January 2006 2 Table of Contents
Guidelines for the Identification of Beneficiaries with REF Risk Factors in Accordance with the REF Entry and Verification Criteria Version 1 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 22 November 2005 Applicable before 1 January 2006 2 Table of Contents
Weighting score:0.1645045
Report_on_REF_Risk_Factors.pdf
Guidelines for the Identification of Beneficiaries with REF Risk Factors in Accordance with the REF Entry and Verification Criteria Version 1 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 22 November 2005 Applicable before 1 January 2006 2 Table of Contents
Guidelines for the Identification of Beneficiaries with REF Risk Factors in Accordance with the REF Entry and Verification Criteria Version 1 Council for Medical Schemes The Council for Medical Schemes was established in terms of the Medical Schemes Act 131 of 1998 to provide regulatory oversight to the medical schemes industry . 22 November 2005 Applicable before 1 January 2006 2 Table of Contents
Weighting score:0.1645045
Dental - CDT 2006_v05.pdf
Dental Practitioners 2006 20 Dec 2005 Page 2 of 51 Version 2006.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the date on which the dental pr ocedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental laboratory service codes shall be reported on
Dental Practitioners 2006 20 Dec 2005 Page 2 of 51 Version 2006.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the date on which the dental pr ocedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental laboratory service codes shall be reported on
Weighting score:0.1601299
Dental Practitioners 2006.pdf
Dental Practitioners 2006 10 Oct 2005 Page 2 of 50 Version 2006.03 dentist for record purposes. 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be bill ed. Use Modifier 8011 with a narrative description. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioner's election. Under the se circumstances a lower fee may be billed. The service
Dental Practitioners 2006 10 Oct 2005 Page 2 of 50 Version 2006.03 dentist for record purposes. 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be bill ed. Use Modifier 8011 with a narrative description. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioner's election. Under the se circumstances a lower fee may be billed. The service
Weighting score:0.1601299
Dental Practitioners 2006_v04.pdf
Dental Practitioners 2006 04 Nov 2005 Page 2 of 50 Version 2006.04 dentist for record purposes. 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be bill ed. Use Modifier 8011 with a narrative description. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioner's election. Under the se circumstances a lower fee may be billed. The service
Dental Practitioners 2006 04 Nov 2005 Page 2 of 50 Version 2006.04 dentist for record purposes. 005 Procedure accompanied by unusual circumstances: In exceptional cases where the proposed fee/benefit is disproporti onately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the patient/medical scheme may be bill ed. Use Modifier 8011 with a narrative description. Under certain circumstances a service or pr ocedure is partially reduced or eliminated at the practitioner's election. Under the se circumstances a lower fee may be billed. The service
Weighting score:0.1601299
Dental Practitioners 2006_v06.pdf
Dental Practitioners 2006 20 Feb 2006 Page 2 of 51 Version 2006.06 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the date on which the dental pr ocedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental laboratory service codes shall be reported on
Dental Practitioners 2006 20 Feb 2006 Page 2 of 51 Version 2006.06 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (PLU S L) shall be indicated on t he dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the rele vant dental procedure code on the date on which the dental pr ocedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental laboratory service codes shall be reported on
Weighting score:0.1601299
Private Hospitals 2006_v04.pdf
Private Hospitals 2006 04 Nov 2005 Page 3 of 35 Version 2006.04 2. If an epidural anaesthetic is given for either a vaginal delivery or a caesarean section, an additional fee (item 011) may b e charged. This comprises of an epidural pack, all consumables used, as well as nursing time. 3. An uncomplicated stay in a nursery for routine observation is included in the maternity fee, as well as phototherapy and rou tine high care observation after delivery for the new born baby. 4. A neonate requiring specialised treatment in a ward, high care or ICU shall
Private Hospitals 2006 04 Nov 2005 Page 3 of 35 Version 2006.04 2. If an epidural anaesthetic is given for either a vaginal delivery or a caesarean section, an additional fee (item 011) may b e charged. This comprises of an epidural pack, all consumables used, as well as nursing time. 3. An uncomplicated stay in a nursery for routine observation is included in the maternity fee, as well as phototherapy and rou tine high care observation after delivery for the new born baby. 4. A neonate requiring specialised treatment in a ward, high care or ICU shall
Weighting score:0.1601299
Circular_15_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1598833
Circular32of2005.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1588933
GuidelinePrepBusinessPlanPursuantApplicationAmalgamationsSchemes.pdf
Guideline for the preparation of a business plan
Guideline for the preparation of a business plan
Weighting score:0.1588933
Circular_3_2005_Amended.pdf
Change Log for Version 02.05 NHRPL Summary Date Added 15-Dec-2004 Items Action ItemID Source Code Type Description TC MP Lab AddOn Status Details 2005-02-17 11:42:19 Printed: Page 1 of 6 Council for Medical Schemes Change Log for Version 02.05 NHRPL 0111 I U-Changed 10178 001 A Paediatric follow-up hospital visits (excluding neonates) by paediatricians and paediatric cardiologists (may only be charged once per day)
Change Log for Version 02.05 NHRPL Summary Date Added 15-Dec-2004 Items Action ItemID Source Code Type Description TC MP Lab AddOn Status Details 2005-02-17 11:42:19 Printed: Page 1 of 6 Council for Medical Schemes Change Log for Version 02.05 NHRPL 0111 I U-Changed 10178 001 A Paediatric follow-up hospital visits (excluding neonates) by paediatricians and paediatric cardiologists (may only be charged once per day)
Weighting score:0.1538478
Education Manual.pdf
BACKGROUND AND INTRODUCTION A. About the Medical Schemes Act To consolidate the laws relating to registered medical schemes; To provide for the establishment of the Counc il for Medical Schemes as a juristic person; To provide for the appointment of the Registrar of Medical Schemes; To make provision for the regi stration and control certain ac tivities of medical schemes; To protect the interest of bene ficiaries of medical schemes; To provide for measures for the c oordination of medical schemes; and To provide incidental matters. (Date of commencement: 1 February, 1999) B.
BACKGROUND AND INTRODUCTION A. About the Medical Schemes Act To consolidate the laws relating to registered medical schemes; To provide for the establishment of the Counc il for Medical Schemes as a juristic person; To provide for the appointment of the Registrar of Medical Schemes; To make provision for the regi stration and control certain ac tivities of medical schemes; To protect the interest of bene ficiaries of medical schemes; To provide for measures for the c oordination of medical schemes; and To provide incidental matters. (Date of commencement: 1 February, 1999) B.
Weighting score:0.1538478
Registered Nurses In Private Practice 2004.pdf
Registered Nurses In Private Practice 2004 09 Sep 2004 Page 2 of 8 Version 01.11 01 CONSULTATIONS: Consultation: This refers to a situation where at the first interaction with the pat ient the registered nurse practitioner pers onally takes down a patient's history, performs an appropriate health examination including obser vations, and plans appropriate intervention(s)/treatment. A consultation ma y not be charged where the sole purpose of the visit was to perform a procedure. In all cases where a consultation is char ged, a diagnosis is essential. Prolonged consultation: This refers to a c onsultation with a duration of longer than 30
Registered Nurses In Private Practice 2004 09 Sep 2004 Page 2 of 8 Version 01.11 01 CONSULTATIONS: Consultation: This refers to a situation where at the first interaction with the pat ient the registered nurse practitioner pers onally takes down a patient's history, performs an appropriate health examination including obser vations, and plans appropriate intervention(s)/treatment. A consultation ma y not be charged where the sole purpose of the visit was to perform a procedure. In all cases where a consultation is char ged, a diagnosis is essential. Prolonged consultation: This refers to a c onsultation with a duration of longer than 30
Weighting score:0.1538478
Circular_70_of_2005_Version_2006_05.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
Weighting score:0.1523016
GFPBP_ApplicationForANewRestructuredBenefitOption_20090916.pdf
G uideline for the preparation of a business plan pursuant to an application for the registration of a new /restructured benefit option (s) as per S ection 33 of the M edical Schemes A ct 131 of 1998 , as amended.
G uideline for the preparation of a business plan pursuant to an application for the registration of a new /restructured benefit option (s) as per S ection 33 of the M edical Schemes A ct 131 of 1998 , as amended.
Weighting score:0.1523016
Circular_32_of_2006_Issues_PMBs.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
Weighting score:0.1507394
Circular_54_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1507394
CMS_News_Sept2008.pdf
September 2008 SPECIALEDITIONThe rules of the game Ð what players in the medical schemes industry should knowCMSnews Pe r spectiveContentsEve ry country has its laws.Governments regulate how fast we can drive,where we can smoke,and how much we can drink.Schools,colleges and universities have their own rules and customs.Your company has policies and procedures that cover everything from your working hours to the way you should dress and behave. Even families have their own unique way of doing things. Our lives are governed by rules and regulations and the private healthcare indus- try is no exception.Medical schemes must have rules that define their relationship with their members and,as a member,you should know
September 2008 SPECIALEDITIONThe rules of the game Ð what players in the medical schemes industry should knowCMSnews Pe r spectiveContentsEve ry country has its laws.Governments regulate how fast we can drive,where we can smoke,and how much we can drink.Schools,colleges and universities have their own rules and customs.Your company has policies and procedures that cover everything from your working hours to the way you should dress and behave. Even families have their own unique way of doing things. Our lives are governed by rules and regulations and the private healthcare indus- try is no exception.Medical schemes must have rules that define their relationship with their members and,as a member,you should know
Weighting score:0.1507394
Unattached Operating Theatre Units 2006pluscpix.pdf
Code Description Ver Add Unattached operating theatres / Day clinics RVU Fee 18 Dec 2006 Page 2 of 8 Version 2007.03 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 282.10 (247.50) 025
Code Description Ver Add Unattached operating theatres / Day clinics RVU Fee 18 Dec 2006 Page 2 of 8 Version 2007.03 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 282.10 (247.50) 025
Weighting score:0.1507394
Unattached Operating Theatre Units 2006_v04.pdf
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Weighting score:0.1507394
Unattached Operating Theatre Units 2006_v05.pdf
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Weighting score:0.1507394
Unattached Operating Theatre Units 2006_v06.pdf
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Unattached Operating Theatre Units 2006 Ward fees (including recovery room) 019 Out-patients facility fee for ambulatory admi ssion - chargeable for patients NOT requiring general anaesthetic- No ward fees applicable. Definition: Item 019 may only be used in conjunction with item 071 which is for pre-booked patients and may not be used in conjunction with items 301, 302, 061 and 335. 04.00 - 268.90 (235.90) 025 Day rate. 04.00 - 308.40 (270.50) Emergency units 035 Theatre drugs The amount charged in respect of medicines and
Weighting score:0.1507394
PBM Review consultation document - Second draft.pdf
2008 PMB Review consultation document: second draft ii Contents 1 Introduction and purpose of this document.......... ................................................... ..1 2 The legislated mandate and the context of the 2008 PMB Review...........................2 2.1 Legislated mandate................................. ................................................... .........2 2.1.1 Medical Schemes Act 131 of 1998.................... .............................................2 2.1.2 Other relevant legislation......................... ................................................... ...2 2.2 Context............................................ ................................................... .................3 2.2.1 Current healthcare financing reform initiatives and the drive towards the implementation of an NHI system.................... ................................................... ......3 2.2.1.1 Relationship between the NHI initiative and the 200 8 PMB Review............................................. ................................................... ..3 2.2.1.2 Restricted access to the private health insurance e nvironment for high-risk individuals.......................... ................................................3 2.2.1.3 Current legislation introduced to Parliament....... ...................................4 2.2.2 Role of PMBs in the protection of
2008 PMB Review consultation document: second draft ii Contents 1 Introduction and purpose of this document.......... ................................................... ..1 2 The legislated mandate and the context of the 2008 PMB Review...........................2 2.1 Legislated mandate................................. ................................................... .........2 2.1.1 Medical Schemes Act 131 of 1998.................... .............................................2 2.1.2 Other relevant legislation......................... ................................................... ...2 2.2 Context............................................ ................................................... .................3 2.2.1 Current healthcare financing reform initiatives and the drive towards the implementation of an NHI system.................... ................................................... ......3 2.2.1.1 Relationship between the NHI initiative and the 200 8 PMB Review............................................. ................................................... ..3 2.2.1.2 Restricted access to the private health insurance e nvironment for high-risk individuals.......................... ................................................3 2.2.1.3 Current legislation introduced to Parliament....... ...................................4 2.2.2 Role of PMBs in the protection of
Weighting score:0.1507394
GeneralNoticeAndBudget_20100324.pdf
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
Weighting score:0.1421185
Circular_40_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1421185
GeneralNoticeAndBudget_20100324.pdf
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
GENERAL NOTICE PROPOSED LEVIES ON MEDICAL SCHEMES ISSUED IN TERMS OF SECTION 3(a) OF THE COUNCIL FOR MEDICAL SCHEMES LEVIES ACT (ACT 58 OF 200 0 ) The Council for Medical Schemes referred to in Section 1 of the Council for Medical Schemes Levies Act, 20 0 0 (Act No. 58 of 2000), hereby proposes the imposition of levies on medical schemes, as set out in this Notice. The proposed levies
Weighting score:0.1421185
CMScript Jan 09 - unlock your chronic benefits.pdf
Pictures: courtesy of www.flickr.com & Microsoft Clip A rt January 2009
Pictures: courtesy of www.flickr.com & Microsoft Clip A rt January 2009
Weighting score:0.1421185
ExplanatoryMemorandumontheModelRules.pdf
EXPLANATORY MEMORANDUM TO THE MODEL RULES Preamble The Medical Schemes Act, 1998, (Act No 131 of 1998) provides for a number of issues to ensure a clear understanding of the relati onship between a medical scheme, its members and stakeholders. These provisions gi ve effect to the intentions of the legislature in a transp arent manner with the aim of preventing unfair discrimination and protecting the in terests of the members as well as the medical scheme. Accordingly, reciprocal rights and obliga tions are observed in this regard. Once approved and registered, the constitution of the
EXPLANATORY MEMORANDUM TO THE MODEL RULES Preamble The Medical Schemes Act, 1998, (Act No 131 of 1998) provides for a number of issues to ensure a clear understanding of the relati onship between a medical scheme, its members and stakeholders. These provisions gi ve effect to the intentions of the legislature in a transp arent manner with the aim of preventing unfair discrimination and protecting the in terests of the members as well as the medical scheme. Accordingly, reciprocal rights and obliga tions are observed in this regard. Once approved and registered, the constitution of the
Weighting score:0.1421185
GFPBP_ApplicationForAmalgamationOfSchemes_20090916.pdf
Guideline for the preparation of a business plan pursuant to an application for an amalgamation of medical schemes as per S ection 63 of the M edical S chemes A ct 131 of 1998 , as amended. September 200 9
Guideline for the preparation of a business plan pursuant to an application for an amalgamation of medical schemes as per S ection 63 of the M edical S chemes A ct 131 of 1998 , as amended. September 200 9
Weighting score:0.1421185
Guideline for the preparation of a business plan pursuant to an application for amalgamation of schemes.pdf
Guideline for the preparation of a business plan
Guideline for the preparation of a business plan
Weighting score:0.1421185
Dieticians 2004.pdf
Dieticians 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DIETICIANS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Dieticians 2004 09 Sep 2004 Page 1 of 3 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DIETICIANS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Weighting score:0.1421185
Physiotherapy 2006pluscpix.pdf
Code Description Ver Add Physiotherapy RVU Fee 18 Dec 2006 Page 2 of 4 Version 2007.03 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services
Code Description Ver Add Physiotherapy RVU Fee 18 Dec 2006 Page 2 of 4 Version 2007.03 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services
Weighting score:0.1421185
Physiotherapy 2006_v04.pdf
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Weighting score:0.1421185
Physiotherapy 2006_v05.pdf
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Weighting score:0.1421185
Physiotherapy 2006_v06.pdf
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Physiotherapy 2006 013 Where the physiotherapist performs treatment away from the tr eatment rooms, travelling costs being more than 16 kilometres in total) to be charged according to the AA-rate. Modifier 0013 must be quoted after the appropriate code numbers to show that thi s rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 04.00 014 Physiotherapy services rendered in a nursing home or hos pital. Modifier 0014 must be quoted after each code. 04.00 016 It is recommended
Weighting score:0.1421185
Podiatry 2004.pdf
Podiatry 2004 09 Sep 2004 Page 2 of 4 Version 01.11 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail spike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperk eratotic lesion; more than four lesions, Reduction of heel fissures, Enucleation of interdigital corns; more than two 46.80 (41.10) 012 Extended care for chronic disease management or ulcer management (applicable to diabet es, arthritis and peripheral vascular diseases) 44.40 (38.90) 013 General podiatric care more than 30 minutes
Podiatry 2004 09 Sep 2004 Page 2 of 4 Version 01.11 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail spike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperk eratotic lesion; more than four lesions, Reduction of heel fissures, Enucleation of interdigital corns; more than two 46.80 (41.10) 012 Extended care for chronic disease management or ulcer management (applicable to diabet es, arthritis and peripheral vascular diseases) 44.40 (38.90) 013 General podiatric care more than 30 minutes
Weighting score:0.1421185
Podiatry 2005.pdf
Podiatry 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY PODIATRISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a
Podiatry 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY PODIATRISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a
Weighting score:0.1421185
Podiatry 2005v2.06.pdf
Podiatry 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY PODIATRISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a
Podiatry 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY PODIATRISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a
Weighting score:0.1421185
Podiatry 2006.pdf
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Weighting score:0.1421185
Podiatry 2006pluscpix.pdf
Code Description Ver Add Podiatry RVU Fee 18 Dec 2006 Page 2 of 4 Version 2007.03 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 54.20 (47.50) 012 Extended care for chronic disease management or
Code Description Ver Add Podiatry RVU Fee 18 Dec 2006 Page 2 of 4 Version 2007.03 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 54.20 (47.50) 012 Extended care for chronic disease management or
Weighting score:0.1421185
Podiatry 2006_v04.pdf
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Weighting score:0.1421185
Podiatry 2006_v05.pdf
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Weighting score:0.1421185
Podiatry 2006_v06.pdf
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Podiatry 2006 011 General podiatric care (30 minutes) including the following: Debride and cut dystrophic nails: six or more, Nail sp ike removal; two to four, Paring or cutting of benign hyperkeratotic lesion; two to four lesions, Paring or cutting of benign hyperkeratotic lesion; more than four lesions, Reduction of heel fissures, E nucleation of interdigital corns; more than two 04.00 7.800 51.60 (45.30) 012 Extended care for chronic disease management or ulcer management (applicable to diabetes, arthritis and peripheral vascular diseases) 04.00 7.400 49.00 (43.00) 013 General podiatric
Weighting score:0.1421185
Speech Therapists and Audiologists 2005.pdf
Speech Therapists and Audiologists 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular
Speech Therapists and Audiologists 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular
Weighting score:0.1421185
Speech Therapists and Audiologists 2005v2.06.pdf
Speech Therapists and Audiologists 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular
Speech Therapists and Audiologists 2005 13 Feb 2005 Page 1 of 3 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular
Weighting score:0.1421185
Six Vacancies at CMS.pdf
The Council for Medical Schemes was established in terms of the Medi cal Schemes Act 131 of 1998 to provide regulatory oversight to the medical scheme industry . SENIOR FINANCIAL ANALYST Three year contract period Commencing - 1 November 2005 COMPLIANCE OFFICER Three year contract period Commencing - 1 November 2005 You will work within a team of CA's and other Financial Analysts and will be responsible for: Analyzing of Annual Financial Statements, financial returns, management accounts and business plans in
The Council for Medical Schemes was established in terms of the Medi cal Schemes Act 131 of 1998 to provide regulatory oversight to the medical scheme industry . SENIOR FINANCIAL ANALYST Three year contract period Commencing - 1 November 2005 COMPLIANCE OFFICER Three year contract period Commencing - 1 November 2005 You will work within a team of CA's and other Financial Analysts and will be responsible for: Analyzing of Annual Financial Statements, financial returns, management accounts and business plans in
Weighting score:0.1421185
CMS_2007_Radiology.pdf
NATIONAL HEALTH REFERENCE PRICE LIST 2007SUBMISSION BY THERADIOLOGICAL SOCIETY OF SOUTH AFRICAFOR SPECIALIST RADIOLOGY and NUCLEAR MEDICINE TARIFFS(Practice numbers 038þ and025þ)MAY 2006TABLE OF CONTENTS1)EXECUTIVE SUMMARY2)AUTHORITY OF THE RADIOLOGICAL SOCIETY OF SOUTH AFRICA TO MAKE THE SUBMISSION3)THE CONSULTANTSa)Allnutt Lüttich and Franklin (ALF) Management Consultantsb)Deloitte Touche & Tohmatsuc)University of Stellenbosch Department of Actuarial Science andStatistics4)THE SCOPE OF RADIOLOGY AND NUCLEAR MEDICINE PRACTICE5)THE STRUCTURE OF THE RADIOLOGY REFERENCE PRICE LIST6)NON-PROPRIETARY NATURE OF THE SUBMISSION7)ACTIVITY TIME, COMPLEXITY AND OVERHEAD COST SURVEYSa)Introductionb)Representative sample sizec)Activity Timesi)Introductionii)Radiologist Timesiii)Radiographer and Sister Timesiv)Equipment / procedure room timesv)Modification of time input datad)Activity Complexity and Responsibility Valuesi)Introductionii)Radiologist Ratingsiii)Radiographer Ratingsiv)Responsibility rating methodology
NATIONAL HEALTH REFERENCE PRICE LIST 2007SUBMISSION BY THERADIOLOGICAL SOCIETY OF SOUTH AFRICAFOR SPECIALIST RADIOLOGY and NUCLEAR MEDICINE TARIFFS(Practice numbers 038þ and025þ)MAY 2006TABLE OF CONTENTS1)EXECUTIVE SUMMARY2)AUTHORITY OF THE RADIOLOGICAL SOCIETY OF SOUTH AFRICA TO MAKE THE SUBMISSION3)THE CONSULTANTSa)Allnutt Lüttich and Franklin (ALF) Management Consultantsb)Deloitte Touche & Tohmatsuc)University of Stellenbosch Department of Actuarial Science andStatistics4)THE SCOPE OF RADIOLOGY AND NUCLEAR MEDICINE PRACTICE5)THE STRUCTURE OF THE RADIOLOGY REFERENCE PRICE LIST6)NON-PROPRIETARY NATURE OF THE SUBMISSION7)ACTIVITY TIME, COMPLEXITY AND OVERHEAD COST SURVEYSa)Introductionb)Representative sample sizec)Activity Timesi)Introductionii)Radiologist Timesiii)Radiographer and Sister Timesiv)Equipment / procedure room timesv)Modification of time input datad)Activity Complexity and Responsibility Valuesi)Introductionii)Radiologist Ratingsiii)Radiographer Ratingsiv)Responsibility rating methodology
Weighting score:0.1410038
King II Report executive_summary.pdf
EXECUTIVE SUMMARY of the KING REPORT 2002 KING COMMITTEE ON CORPORATE GOVERNANCE LOGO : PROUDLY SOUTH AFRICAN MARCH 2002
EXECUTIVE SUMMARY of the KING REPORT 2002 KING COMMITTEE ON CORPORATE GOVERNANCE LOGO : PROUDLY SOUTH AFRICAN MARCH 2002
Weighting score:0.1332361
SA_ICD-10_Coding_Standards_V3_200903.pdf
South African ICD - 10 C oding S tandards Developed to assist the clinical coder in the South African environment The South African ICD - 10 Cod ing Standards, Version 3 (as at March 200 9 ) Compiled by the National Task Team for the Implementation of ICD - 10 The S A IC D - 10 Coding Standards
South African ICD - 10 C oding S tandards Developed to assist the clinical coder in the South African environment The South African ICD - 10 Cod ing Standards, Version 3 (as at March 200 9 ) Compiled by the National Task Team for the Implementation of ICD - 10 The S A IC D - 10 Coding Standards
Weighting score:0.1332361
GFPBP_MedicalSchemeNotMeetingStatutorySolvency_20090916.pdf
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended September 2009 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0% 20.0% 25. 0%
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended September 2009 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0% 20.0% 25. 0%
Weighting score:0.1256162
GuidelineSchmNtMtngMnmmSlvncy2013.pdf
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0%
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0%
Weighting score:0.1256162
GuidelinOfPrepMeetingSolvencyReqRegulation29.pdf
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended February 2012 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0%
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended February 2012 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0%
Weighting score:0.1256162
Circular18of2005.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1243537
Circular26of 2005.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Gando Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1243537
Circular_36_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1243537
Circular_43_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1243537
Circular_8_of_2006_Benefit_design_structure_15_Feb.pdf
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1243537
CMScript1Of2013_2014.pdf
The thyroid: critical to your good health The thyroid gland is located below the Adam's apple and wraps around the trachea (windpipe) and produces hor - mones that are essential to our growth and the metabo - lism of our bodies. There are a number of different types of thyroid diseases and they can have a major impact on our health. However, thyroid disease can usually be success - treated early. The thyroid hormones The thyroid hormones include thyroxine (T4), triiodothyro - nine (T3) and thyroid stimulating hormone (TSH). The pro - duction of thyroid hormones
The thyroid: critical to your good health The thyroid gland is located below the Adam's apple and wraps around the trachea (windpipe) and produces hor - mones that are essential to our growth and the metabo - lism of our bodies. There are a number of different types of thyroid diseases and they can have a major impact on our health. However, thyroid disease can usually be success - treated early. The thyroid hormones The thyroid hormones include thyroxine (T4), triiodothyro - nine (T3) and thyroid stimulating hormone (TSH). The pro - duction of thyroid hormones
Weighting score:0.1243537
AuditorQuestionnaire_HelpFile_1.pdf
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE 2011 HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 14 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ................................ ...... 3 HOW SHOULD YOU REGISTER ................................ ................................ ......... 4 Login
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE 2011 HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 14 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ................................ ...... 3 HOW SHOULD YOU REGISTER ................................ ................................ ......... 4 Login
Weighting score:0.1243537
AuditorQuestionnaire_HelpFile_20090612_1.pdf
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 13 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ................................ ...... 3 HOW SHOULD YOU REGISTER ................................ ................................ ......... 4 Login onto auditor questionnaire
HELF FILE WITH REGARDS TO THE AUDITOR APPROVAL QUESTIONNAIRE HELP FILE AUDITOR APPROVAL QUESTIONNAIRE Page 2 of 13 TABLE OF CONTENTS REQUIREMENTS FOR APPROVAL OF AN AUDITOR PER MEDICAL SCHEMES ACT 3 WHO SHOULD APPLY FOR REGISTRATION AS A USER ................................ ...... 3 HOW SHOULD YOU REGISTER ................................ ................................ ......... 4 Login onto auditor questionnaire
Weighting score:0.1243537
New Clicks Judgment of the Court only NO 1.pdf
CONSTITUTIONAL COUR T OF SOUTH AFRICA Case CCT 59/04 MINISTER OF HEALTH First Applicant PROFESSOR D McINTYRE NO Second Applicant versus NEW CLICKS SOUTH AFRICA (PTY) LTD First Respondent PHARMACEUTICAL SOCIETY OF SOUTH AFRICA Second Respondent UNITED SOUTH AFRICAN PHARMA CIES Third Respondent LA TANDT AND ASSOCIATES (PTY) LTD Fourth Respondent IRVINE AND MILLER (PTY) LTD Fifth Respondent MEDICROSS HEALTH CARE HOLD INGS LTD Sixth Respondent NETWORK HEALTH CARE HOLDINGS LTD Seventh Respondent I M DAVIS NO 2 CC Eighth Respondent together with TREATMENT ACTION CAMPAIGN
CONSTITUTIONAL COUR T OF SOUTH AFRICA Case CCT 59/04 MINISTER OF HEALTH First Applicant PROFESSOR D McINTYRE NO Second Applicant versus NEW CLICKS SOUTH AFRICA (PTY) LTD First Respondent PHARMACEUTICAL SOCIETY OF SOUTH AFRICA Second Respondent UNITED SOUTH AFRICAN PHARMA CIES Third Respondent LA TANDT AND ASSOCIATES (PTY) LTD Fourth Respondent IRVINE AND MILLER (PTY) LTD Fifth Respondent MEDICROSS HEALTH CARE HOLD INGS LTD Sixth Respondent NETWORK HEALTH CARE HOLDINGS LTD Seventh Respondent I M DAVIS NO 2 CC Eighth Respondent together with TREATMENT ACTION CAMPAIGN
Weighting score:0.1243537
Occupational and Art Therapy 2005.pdf
Occupational and Art Therapy 2005 13 Feb 2005 Page 2 of 6 Version 02.05 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. U 012 Every practitioner shall render a monthly account in respect of any service
Occupational and Art Therapy 2005 13 Feb 2005 Page 2 of 6 Version 02.05 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. U 012 Every practitioner shall render a monthly account in respect of any service
Weighting score:0.1243537
Occupational and Art Therapy 2005v2.06.pdf
Occupational and Art Therapy 2005 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. U 012 Every practitioner shall render a monthly account in respect of any service render ed during the
Occupational and Art Therapy 2005 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. U 012 Every practitioner shall render a monthly account in respect of any service render ed during the
Weighting score:0.1243537
Occupational and Art Therapy 2006.pdf
Occupational and Art Therapy 2006 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 2004. 00 012 Every practitioner shall render a monthly account in respect of any service render ed during the
Occupational and Art Therapy 2006 011 Where the therapist performs treatments away from the treat ment rooms, travelling costs to be charged according to AA rates e.g. for domicilliary treatments or treatments in nursing homes. Modifier 0011 must be quoted after the appropriate code numbers to show that this rule is applicable. Please note that although only some medical schemes accept responsibility for the payment of transport expenses, others do so in exceptional cases only. 2004. 00 012 Every practitioner shall render a monthly account in respect of any service render ed during the
Weighting score:0.1243537
PressRelease12Of2014.pdf
PRESS RELEASE Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com
PRESS RELEASE Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com
Weighting score:0.1243537
PressRelease6Of2011.pdf
PRESS RELEASE Chairperson: Prof. W Pick Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028
PRESS RELEASE Chairperson: Prof. W Pick Chief Executive & Registrar: Dr M Gantsho Block E Hadefields Office Park 1267 Pretorius Street Hatfield Pretoria 0028
Weighting score:0.1243537
BDIschaemicHD.pdf
Draft Benefit Definition: Ischaemic Heart Disease PMB DTP code: 907E 23 March 2012 Contents 1 Introduction ................................ ................................ ................................ ................................ .... 3 1.1 Scope ................................ ................................ ................................ ................................ ....... 3 1.2 Burden of disease ................................ ................................ ................................ .................... 3 1.3 Percutaneous procedures PMB level of care
Draft Benefit Definition: Ischaemic Heart Disease PMB DTP code: 907E 23 March 2012 Contents 1 Introduction ................................ ................................ ................................ ................................ .... 3 1.1 Scope ................................ ................................ ................................ ................................ ....... 3 1.2 Burden of disease ................................ ................................ ................................ .................... 3 1.3 Percutaneous procedures PMB level of care
Weighting score:0.1230782
Managedhealthcare_Policy_doc_2003.pdf
Version 1 1 MANAGED HEALTH CARE POLICY DOCUMENT Version 1 (August 2003) 1. Introduction 1.1. A new set of regulations governing managed health care activities in South Africa took effect on 1 January 2003, by way of amendment to the general regulations 1 made in term s of the Medical Schemes Act, 1998
Version 1 1 MANAGED HEALTH CARE POLICY DOCUMENT Version 1 (August 2003) 1. Introduction 1.1. A new set of regulations governing managed health care activities in South Africa took effect on 1 January 2003, by way of amendment to the general regulations 1 made in term s of the Medical Schemes Act, 1998
Weighting score:0.11917
Managedhealthcare_Policy_doc_2003.pdf
Version 1 1 MANAGED HEALTH CARE POLICY DOCUMENT Version 1 (August 2003) 1. Introduction 1.1. A new set of regulations governing managed health care activities in South Africa took effect on 1 January 2003, by way of amendment to the general regulations 1 made in term s of the Medical Schemes Act, 1998
Version 1 1 MANAGED HEALTH CARE POLICY DOCUMENT Version 1 (August 2003) 1. Introduction 1.1. A new set of regulations governing managed health care activities in South Africa took effect on 1 January 2003, by way of amendment to the general regulations 1 made in term s of the Medical Schemes Act, 1998
Weighting score:0.11917
Dental Therapy 2006_v06.pdf
Dental Therapy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL PRACTITIONERS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price
Dental Therapy 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL PRACTITIONERS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price
Weighting score:0.11917
MSREGS19DEC2003.pdf
MEDICAL SCHEMES ACT 131 OF 1998REGULATIONSDEPARTMENT OF HEALTH GNR.1262 20 October 1999 as amended byNotice Government Gazette Date R.570212565 June 2000 R.6502131330 June 2000 R.247231931 March 2002 R.1360240074 November 2002 1397255376 October 2003The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131 of 1998), after consultation with the Council for Medical Schemes, made the regulations in the Schedule. M.E. TSHABALALA MSIMANG Minister of Health SCHEDULE ARRANGEMENT OF REGULATIONS CHAPTER 1 DEFINITIONS 1.Definitions CHAPTER 2 ADMINISTRATIVE REQUIREMENTS 2.Registration of medical scheme 3.Proof of membership 4.Administration of a medical scheme 5.Accounts by suppliers of services 6.Manner of payment of benefits 6A.Disclosure of trustee remuneration CHAPTER 3 CONTRIBUTIONS AND BENEFITS 7.Definitions 8.Prescribed Minimum Benefits 9.Limits on benefits 9A.Non-accumulation of benefits 9B.Contributions in respect of dependants 10.Personal medical savings
MEDICAL SCHEMES ACT 131 OF 1998REGULATIONSDEPARTMENT OF HEALTH GNR.1262 20 October 1999 as amended byNotice Government Gazette Date R.570212565 June 2000 R.6502131330 June 2000 R.247231931 March 2002 R.1360240074 November 2002 1397255376 October 2003The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131 of 1998), after consultation with the Council for Medical Schemes, made the regulations in the Schedule. M.E. TSHABALALA MSIMANG Minister of Health SCHEDULE ARRANGEMENT OF REGULATIONS CHAPTER 1 DEFINITIONS 1.Definitions CHAPTER 2 ADMINISTRATIVE REQUIREMENTS 2.Registration of medical scheme 3.Proof of membership 4.Administration of a medical scheme 5.Accounts by suppliers of services 6.Manner of payment of benefits 6A.Disclosure of trustee remuneration CHAPTER 3 CONTRIBUTIONS AND BENEFITS 7.Definitions 8.Prescribed Minimum Benefits 9.Limits on benefits 9A.Non-accumulation of benefits 9B.Contributions in respect of dependants 10.Personal medical savings
Weighting score:0.1175032
MSREGS19July2004.pdf
MEDICAL SCHEMES ACT 131 OF 1998TABLE OF CONTENTS REGULATIONS GNR.1262 of 20 October 1999 Regulations GN 1402 of 6 October 2003 Therapeutic algorithms for chronic conditions NOTICES GN 225 of 11 February 2004 Registered Medical Schemes GN 227 of 20 February 2004 Fees payable to brokers BN 73 of 30 June 2004 Notice of declaration of undesirable business practice in terms of section 61 (1) of the Medical Schemes Act, 1998 (Act No. 131 of 1998)REGULATIONSGNR.1262 of 20 October 1999: Regulations DEPARTMENT OF HEALTH as amended byNotice Government Gazette Date R.570212565 June 2000 R.6502131330 June 2000 R.247231931 March 2002 R.1360240074 November 2002 1397255376 October 2003The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131
MEDICAL SCHEMES ACT 131 OF 1998TABLE OF CONTENTS REGULATIONS GNR.1262 of 20 October 1999 Regulations GN 1402 of 6 October 2003 Therapeutic algorithms for chronic conditions NOTICES GN 225 of 11 February 2004 Registered Medical Schemes GN 227 of 20 February 2004 Fees payable to brokers BN 73 of 30 June 2004 Notice of declaration of undesirable business practice in terms of section 61 (1) of the Medical Schemes Act, 1998 (Act No. 131 of 1998)REGULATIONSGNR.1262 of 20 October 1999: Regulations DEPARTMENT OF HEALTH as amended byNotice Government Gazette Date R.570212565 June 2000 R.6502131330 June 2000 R.247231931 March 2002 R.1360240074 November 2002 1397255376 October 2003The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131
Weighting score:0.1175032
National Health Act No 61 2003.pdf
Government Gazette REPUBLIC OF SOUTH AFRICA Vol. 469 Cape Town 23 July 2004No. 26595 THE PRESIDENCY No. 869 23 July 2004 It is hereby notified that the President has assented to the following Act, which is hereby published for general information: No. 61 of 2003: National Health Act, 2004. AIDS HELPLINE: 0800-123- 22 Prevention is the cure 2 No. 26595 GOVERNMENT GAZETTE, 23 JULY
Government Gazette REPUBLIC OF SOUTH AFRICA Vol. 469 Cape Town 23 July 2004No. 26595 THE PRESIDENCY No. 869 23 July 2004 It is hereby notified that the President has assented to the following Act, which is hereby published for general information: No. 61 of 2003: National Health Act, 2004. AIDS HELPLINE: 0800-123- 22 Prevention is the cure 2 No. 26595 GOVERNMENT GAZETTE, 23 JULY
Weighting score:0.1175032
CMSNews201411.pdf
FIT AND PROPER CMS NewsIssue 2 November 2014The Council for Medical Schemes' Plus BOARD OF TRUSTEES 2013/14 CMS ANNUAL REPORT SCA CONFIRMS NEED FOR ETHICS AND GOOD GOVERNANCE the ethics and governance issue ADMINISTRATORS ROLE IN THE GOVERNANCE OF MEDICAL SCHEMES 2 CMS News www.medicalschemes.com 04 Governance Only as good as the will to do it 06 What is fit and proper? Setting the scene for Board of Trustees 11 Fiduciary responsibilities for Board of Trustees 15 Bravery
FIT AND PROPER CMS NewsIssue 2 November 2014The Council for Medical Schemes' Plus BOARD OF TRUSTEES 2013/14 CMS ANNUAL REPORT SCA CONFIRMS NEED FOR ETHICS AND GOOD GOVERNANCE the ethics and governance issue ADMINISTRATORS ROLE IN THE GOVERNANCE OF MEDICAL SCHEMES 2 CMS News www.medicalschemes.com 04 Governance Only as good as the will to do it 06 What is fit and proper? Setting the scene for Board of Trustees 11 Fiduciary responsibilities for Board of Trustees 15 Bravery
Weighting score:0.1175032
ICD-10TaskTeamReviewDoc_Jan04Mar2010.pdf
ICD - 10 IMPLEMENTATION REVIEW JANUARY 2004 MARCH 20 10 NATIONAL TASK TEAM ON ICD - 10 IMPLEMENTATION March 2010 National ICD10 Task Team Review Document 2 ACKNOWLEDGEMENTS The National Department of Health and the Council for Medical Schemes would like to thank all
ICD - 10 IMPLEMENTATION REVIEW JANUARY 2004 MARCH 20 10 NATIONAL TASK TEAM ON ICD - 10 IMPLEMENTATION March 2010 National ICD10 Task Team Review Document 2 ACKNOWLEDGEMENTS The National Department of Health and the Council for Medical Schemes would like to thank all
Weighting score:0.1175032
GNR1262 of 20 October 1999.pdf
MEDICAL SCHEMES ACT 131 OF 1998 REGULATIONS GNR.1262 of 20 October 1999: Regulations DEPARTMENT OF HEALTH as amended by Notice Government Gazette Date R.570 21256 5 June 2000 R.650 21313 30 June 2000 R.247 23193 1 March 2002 R.1360 24007 4 November 2002 1397 25537 6 October 2003 R.1410 27055 3 December 2004 The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131 of
MEDICAL SCHEMES ACT 131 OF 1998 REGULATIONS GNR.1262 of 20 October 1999: Regulations DEPARTMENT OF HEALTH as amended by Notice Government Gazette Date R.570 21256 5 June 2000 R.650 21313 30 June 2000 R.247 23193 1 March 2002 R.1360 24007 4 November 2002 1397 25537 6 October 2003 R.1410 27055 3 December 2004 The Minister of Health has, in terms of section 67 of the Medical Schemes Act, 1998 (Act No. 131 of
Weighting score:0.1087868
2009 Annual Return Help File final.pdf
HELP FILE WITH REGARDS TO THE 2009 ANNUAL STATUTORY RETURN HELP FILE 200 9 ANNUAL STATUTORY RETURN Page 2 of 135 LOGIN ONTO ANNUAL ST ATUTORY RETURN
HELP FILE WITH REGARDS TO THE 2009 ANNUAL STATUTORY RETURN HELP FILE 200 9 ANNUAL STATUTORY RETURN Page 2 of 135 LOGIN ONTO ANNUAL ST ATUTORY RETURN
Weighting score:0.1087868
SAICD_10CodingStandards_20100712.pdf
South African ICD - 10 C oding S tandards Developed to assist the clinical coder in the South African environment The South African ICD - 10 Cod ing Standards, Version 4 (as at June 20 1 0) Compiled by the National Task Team for the Implementation of ICD - 10 The S A ICD - 10
South African ICD - 10 C oding S tandards Developed to assist the clinical coder in the South African environment The South African ICD - 10 Cod ing Standards, Version 4 (as at June 20 1 0) Compiled by the National Task Team for the Implementation of ICD - 10 The S A ICD - 10
Weighting score:0.1087868
New Clicks Judgment CCT 59-04 NO 2.pdf
CONSTITUTIONAL COUR T OF SOUTH AFRICA Case CCT 59/04 MINISTER OF HEALTH First Applicant PROFESSOR D McINTYRE NO Second Applicant versus NEW CLICKS SOUTH AFRICA (PTY) LTD First Respondent PHARMACEUTICAL SOCIETY OF SOUTH AFRICA Second Respondent UNITED SOUTH AFRICAN PHARMA CIES Third Respondent LA TANDT AND ASSOCIATES (PTY) LTD Fourth Respondent IRVINE AND MILLER (PTY) LTD Fifth Respondent MEDICROSS HEALTH CARE HOLD INGS LTD Sixth Respondent NETWORK HEALTH CARE HOLDINGS LTD Seventh Respondent I M DAVIS NO 2 CC Eighth Respondent together with TREATMENT ACTION CAMPAIGN
CONSTITUTIONAL COUR T OF SOUTH AFRICA Case CCT 59/04 MINISTER OF HEALTH First Applicant PROFESSOR D McINTYRE NO Second Applicant versus NEW CLICKS SOUTH AFRICA (PTY) LTD First Respondent PHARMACEUTICAL SOCIETY OF SOUTH AFRICA Second Respondent UNITED SOUTH AFRICAN PHARMA CIES Third Respondent LA TANDT AND ASSOCIATES (PTY) LTD Fourth Respondent IRVINE AND MILLER (PTY) LTD Fifth Respondent MEDICROSS HEALTH CARE HOLD INGS LTD Sixth Respondent NETWORK HEALTH CARE HOLDINGS LTD Seventh Respondent I M DAVIS NO 2 CC Eighth Respondent together with TREATMENT ACTION CAMPAIGN
Weighting score:0.1087868
Consolidated Regulatory Plan and Budget 2008_9_Draft4.pdf
COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 200 8 / 9 STRATEGIC OBJECTIVES Secure an appropriate level of protection of beneficiaries o medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial
COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 200 8 / 9 STRATEGIC OBJECTIVES Secure an appropriate level of protection of beneficiaries o medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial
Weighting score:0.1087868
Circular 1 of 2006 Costing spreadsheet.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
Weighting score:0.1065889
Circular_44_2004.pdf
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Chairperson: Prof. Nicky Padayachee Vice-Chairperson: Ms Ga ndo Matyumza Chief Executive & Registrar: Patrick Masobe A STATUTORY BODY ESTABLISHED IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 (ACT 131 OF 1998) Phone: +27 (0) 12 431-0500 Fax: +27 (0) 12 430-7644 Private Bag X34, HATFIELD, 0028 Hadefields Block E, 1267 Pretorius Street, HATFIELD
Weighting score:0.1065889
CMScript10Of2014.pdf
CM S cript Member of a medical scheme? Issue 10 of 2014 The total number of persons living with HIV in South Af - rica increased from an estimated 4 million in 2002 to over 5 million in 2013. This means that an estimated 10% of the total population was HIV positive in 2013. For adults (non- paediatrics), aged 15-49 years, approximately 15, 9% of this population is HIV positive. Antiretroviral Therapy (ART) has, however, converted HIV infections from
CM S cript Member of a medical scheme? Issue 10 of 2014 The total number of persons living with HIV in South Af - rica increased from an estimated 4 million in 2002 to over 5 million in 2013. This means that an estimated 10% of the total population was HIV positive in 2013. For adults (non- paediatrics), aged 15-49 years, approximately 15, 9% of this population is HIV positive. Antiretroviral Therapy (ART) has, however, converted HIV infections from
Weighting score:0.1065889
Radiography 2004.pdf
Radiography 2004 09 Sep 2004 Page 1 of 5 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Radiography 2004 09 Sep 2004 Page 1 of 5 Version 01.11 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to pati ents. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equival ent to a
Weighting score:0.1065889
Radiography 2005.pdf
Radiography 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Radiography 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Weighting score:0.1065889
Radiography 2005v2.06.pdf
Radiography 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Radiography 2005 13 Feb 2005 Page 1 of 5 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Weighting score:0.1065889
Radiography 2006pluscpix.pdf
Radiography 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Radiography 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1065889
Radiography 2006_v04.pdf
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1065889
Radiography 2006_v05.pdf
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1065889
Radiography 2006_v06.pdf
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price list. It
Weighting score:0.1065889
Speech Therapists and Audiologists 2006.pdf
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified
Weighting score:0.1065889
Speech Therapists and Audiologists 2006pluscpix.pdf
Speech Therapists and Audiologists 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Speech Therapists and Audiologists 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Weighting score:0.1065889
Speech Therapists and Audiologists 2006_v04.pdf
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Weighting score:0.1065889
Speech Therapists and Audiologists 2006_v05.pdf
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Weighting score:0.1065889
Speech Therapists and Audiologists 2006_v06.pdf
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
Speech Therapists and Audiologists 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY SPEECH TH ERAPISTS AND AUDIOLOGISTS, EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of
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DR BERNDT PRESENTATION JUNE 2005 amend THA.pdf
Introduction Introduction Cost Cost - - effectiveness effectiveness Protocols Protocols Codes & Fees Codes & Fees Structur Structur al imaging al imaging Metabol Metabol ic Imaging ic Imaging Radiology General Xray CT Ultrasound MagneticResonance Imaging Nuclear Medicine Planar scintigraphy SPECT PET FDG FDG - - PET PET - - the "smart" image the "smart" image FDG Fluorodeoxy FDG Fluorodeoxy - - Glucose Glucose FDG Fluorodeoxy FDG Fluorodeoxy - - Glucose Glucose Metabolically behaves like Metabolically behaves like glucose glucose Measure rate of metabolism Measure rate of metabolism Due to the relatively long half Due to the relatively long half - - life, life, it can be distributed it can be distributed Therefore it can apply
Introduction Introduction Cost Cost - - effectiveness effectiveness Protocols Protocols Codes & Fees Codes & Fees Structur Structur al imaging al imaging Metabol Metabol ic Imaging ic Imaging Radiology General Xray CT Ultrasound MagneticResonance Imaging Nuclear Medicine Planar scintigraphy SPECT PET FDG FDG - - PET PET - - the "smart" image the "smart" image FDG Fluorodeoxy FDG Fluorodeoxy - - Glucose Glucose FDG Fluorodeoxy FDG Fluorodeoxy - - Glucose Glucose Metabolically behaves like Metabolically behaves like glucose glucose Measure rate of metabolism Measure rate of metabolism Due to the relatively long half Due to the relatively long half - - life, life, it can be distributed it can be distributed Therefore it can apply
Weighting score:0.1065889
Draft Medical Schemes Bill 2008.pdf
STAATSKOERANT, 2 JUNlE 2008 No.31114 7 19G. (1) Any money of the Fund which is not requred for immediate allocation may be invested in accordance ~'lt11 the Public Finance Management Act. 1999 (Act No 1 of 1999) and may be M ithdrawn when required (2) Any uncxpcndcd balancc of thc inoncy of tllc Fund at thc cnd of any financial ycar shall bc camcd forward as a crcdit to the ncxt financial ycar Separate financial records and financial statements 19H. 11 ) Thc Council nwst cause scparatc accoun~ing records for tl1c Fund to be rnaintaincd must - preparc separatc annual
STAATSKOERANT, 2 JUNlE 2008 No.31114 7 19G. (1) Any money of the Fund which is not requred for immediate allocation may be invested in accordance ~'lt11 the Public Finance Management Act. 1999 (Act No 1 of 1999) and may be M ithdrawn when required (2) Any uncxpcndcd balancc of thc inoncy of tllc Fund at thc cnd of any financial ycar shall bc camcd forward as a crcdit to the ncxt financial ycar Separate financial records and financial statements 19H. 11 ) Thc Council nwst cause scparatc accoun~ing records for tl1c Fund to be rnaintaincd must - preparc separatc annual
Weighting score:0.100493
GFPBP_ApplicationForANewMedicalScheme_20090916.pdf
Guideline for the preparation of a business plan pursuant to an application for the registration of a new medical scheme as per S ection 2 2 of the M edical S chemes A ct 131 of 1998 , as amended.
Guideline for the preparation of a business plan pursuant to an application for the registration of a new medical scheme as per S ection 2 2 of the M edical S chemes A ct 131 of 1998 , as amended.
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AnalysisOfSRM2013.pdf
Analysis of the Schemes Risk Measurement returns in 2013 Research and Monitoring Unit September 201 4 i Table of Contents 1. Executive summary ................................ ................................ ................................ ........................ 1 2. Introduction ................................ ................................ ................................ ................................ .... 3 3. Purpose of the report ................................ ................................ ................................ ..................... 3 4. S RM
Analysis of the Schemes Risk Measurement returns in 2013 Research and Monitoring Unit September 201 4 i Table of Contents 1. Executive summary ................................ ................................ ................................ ........................ 1 2. Introduction ................................ ................................ ................................ ................................ .... 3 3. Purpose of the report ................................ ................................ ................................ ..................... 3 4. S RM
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Planned Methodology for REF Contribution Table 2006 Final.pdf
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Planned Methodology for REF Contribution Table 2006 RETAP Recommendations Report No. 6 of 2005 Adopted at RETAP Meeting 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Planned Methodology for REF Contribution Table 2006 RETAP Recommendations Report No. 6 of 2005 Adopted at RETAP Meeting 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance
Weighting score:0.100493
ARHelpFile2010_1.pdf
HELP FILE WITH REGARDS TO THE 2010 ANNUAL STATUTORY RETURN HELP FILE: 20 10 ANNUAL STATUTORY RETURN Page 2 of 132 INDEX LOGIN ONTO
HELP FILE WITH REGARDS TO THE 2010 ANNUAL STATUTORY RETURN HELP FILE: 20 10 ANNUAL STATUTORY RETURN Page 2 of 132 INDEX LOGIN ONTO
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Final_Consolidated_Regplan_2006.pdf
Page 1 of 85 COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 2006/7 Page 2 of 85 STRATEGIC OBJECTIVES Secure an appropriate level of protecti on of beneficiaries o medical schemes and the public by authorizing the co nduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trus tees, beneficiaries
Page 1 of 85 COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 2006/7 Page 2 of 85 STRATEGIC OBJECTIVES Secure an appropriate level of protecti on of beneficiaries o medical schemes and the public by authorizing the co nduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trus tees, beneficiaries
Weighting score:0.09930833
Circular_69_of_2005_Invitation_for_submissions.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
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StandardisationManual.pdf
FINAL DOCUMENT RECOMMENDATIONS OF THE COMMITTEE ON STANDARDISATION OF DATA AND BILLING PRACTICES FEBRUARY 2003 Final Document 2ACKNOWLEDGEMENTS The Council for Medical Schemes would like to thank all the participants who gave their time freely in the development of this docu ment. We would like to thank specifically all the Committee members and sub committee members who contributed tremendously to the development of this document. In addition
FINAL DOCUMENT RECOMMENDATIONS OF THE COMMITTEE ON STANDARDISATION OF DATA AND BILLING PRACTICES FEBRUARY 2003 Final Document 2ACKNOWLEDGEMENTS The Council for Medical Schemes would like to thank all the participants who gave their time freely in the development of this docu ment. We would like to thank specifically all the Committee members and sub committee members who contributed tremendously to the development of this document. In addition
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Medical Schemes Act 1998.pdf
S TATUTES OF THE R EPUBLIC OF S OUTH AFRICA-MEDICmE, D ENTISTRY AND PHAWACY MEDICAL SCHEMES ACT NO. 131 OF 1998 [A SSENTED TO 20 N OVEMBER , 1998] [D ATE OF C OMMENCEMENT TO BE P ROCLAIMED ] (English text signed by the President) ACT To consolidate the laws relating to registered medical schemes; to provide for the esta- blishment of the Council for Medical
S TATUTES OF THE R EPUBLIC OF S OUTH AFRICA-MEDICmE, D ENTISTRY AND PHAWACY MEDICAL SCHEMES ACT NO. 131 OF 1998 [A SSENTED TO 20 N OVEMBER , 1998] [D ATE OF C OMMENCEMENT TO BE P ROCLAIMED ] (English text signed by the President) ACT To consolidate the laws relating to registered medical schemes; to provide for the esta- blishment of the Council for Medical
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msact.pdf
S TATUTES OF THE R EPUBLIC OF S OUTH AFRICA-MEDICmE, D ENTISTRY AND PHAWACY MEDICAL SCHEMES ACT NO. 131 OF 1998 [A SSENTED TO 20 N OVEMBER , 1998] [D ATE OF C OMMENCEMENT TO BE P ROCLAIMED ] (English text signed by the President) ACT To consolidate the laws relating to registered medical schemes; to provide for the esta- blishment of the Council for Medical
S TATUTES OF THE R EPUBLIC OF S OUTH AFRICA-MEDICmE, D ENTISTRY AND PHAWACY MEDICAL SCHEMES ACT NO. 131 OF 1998 [A SSENTED TO 20 N OVEMBER , 1998] [D ATE OF C OMMENCEMENT TO BE P ROCLAIMED ] (English text signed by the President) ACT To consolidate the laws relating to registered medical schemes; to provide for the esta- blishment of the Council for Medical
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MSACT19DEC2003.pdf
MEDICAL SCHEMES ACT NO. 131 OF 1998[ASSENTED TO 20 NOVEMBER, 1998] [DATE OF COMMENCEMENT: 1 FEBRUARY, 1999] ( English text signed by the President ) as amended by Medical Schemes Amendment Act, No. 55 of 2001 Medical Schemes Amendment Act, No. 62 of 2002 Intelligence Services Act, No. 65 of 2002 ACT To consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures
MEDICAL SCHEMES ACT NO. 131 OF 1998[ASSENTED TO 20 NOVEMBER, 1998] [DATE OF COMMENCEMENT: 1 FEBRUARY, 1999] ( English text signed by the President ) as amended by Medical Schemes Amendment Act, No. 55 of 2001 Medical Schemes Amendment Act, No. 62 of 2002 Intelligence Services Act, No. 65 of 2002 ACT To consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures
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MSACT19July2004.pdf
MEDICAL SCHEMES ACT NO. 131 OF 1998[ASSENTED TO 20 NOVEMBER, 1998] [DATE OF COMMENCEMENT: 1 FEBRUARY, 1999] ( English text signed by the President ) as amended by Medical Schemes Amendment Act, No. 55 of 2001 Medical Schemes Amendment Act, No. 62 of 2002 Intelligence Services Act, No. 65 of 2002[with effect from 20 February, 2003see title DEFENCE]General Intelligence Laws Amendment Act, No. 52 of 2003[with effect from 28 February, 2003see title DEFENCE]Prevention and Combating of Corrupt Activities Act, No. 12 of 2004[with effect from 27 April, 2004see title CRIMINAL LAW AND PROCEDURE] ACT To consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council
MEDICAL SCHEMES ACT NO. 131 OF 1998[ASSENTED TO 20 NOVEMBER, 1998] [DATE OF COMMENCEMENT: 1 FEBRUARY, 1999] ( English text signed by the President ) as amended by Medical Schemes Amendment Act, No. 55 of 2001 Medical Schemes Amendment Act, No. 62 of 2002 Intelligence Services Act, No. 65 of 2002[with effect from 20 February, 2003see title DEFENCE]General Intelligence Laws Amendment Act, No. 52 of 2003[with effect from 28 February, 2003see title DEFENCE]Prevention and Combating of Corrupt Activities Act, No. 12 of 2004[with effect from 27 April, 2004see title CRIMINAL LAW AND PROCEDURE] ACT To consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council
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msbill.pdf
REPUBLIC OF SOUTH AFRICA MEDICAL SCHEMES BILL (As introduced in the National Assembly) (MINISTER OF H EALTH ) [B IM--9W No. ofcop,cs printed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z6W lsBN 0621285064 19!?8 -og-22 ., ~ BILL
REPUBLIC OF SOUTH AFRICA MEDICAL SCHEMES BILL (As introduced in the National Assembly) (MINISTER OF H EALTH ) [B IM--9W No. ofcop,cs printed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z6W lsBN 0621285064 19!?8 -og-22 ., ~ BILL
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Circular36of2005.pdf
GUIDELINES ON SUBMISSION OF ICD-10 CODES National Task Team on ICD-10 Implementation Technical Document Private Health Information Standards Committee AUGUST 2005 Table of Contents Including ICD-10 codes in claim data capturing and submission ......................................4 1. Data capturing on Practice Management software .................................................4
GUIDELINES ON SUBMISSION OF ICD-10 CODES National Task Team on ICD-10 Implementation Technical Document Private Health Information Standards Committee AUGUST 2005 Table of Contents Including ICD-10 codes in claim data capturing and submission ......................................4 1. Data capturing on Practice Management software .................................................4
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GFPBP_MedicalSchemeNotMeetingStatutorySolvency.pdf
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended February 2011 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0%
Guideline for the preparation of a business plan where a medical scheme is not meeting the statutory solvency requirements as per Regulation 29 of the Medical Schemes Act 131 of 1998, as amended February 2011 Prescribed phase - in solvency levels as per Regulation 29 0.0% 5.0% 10.0% 15.0%
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ICD10_Implementation_Review_October2006.pdf
ICD-10 Implementation Review January 2004 - October 2006 National Task Team On ICD-10 Implementation October 2006 ACKNOWLEDGEMENTS The National Department of Health and the Council for Medical Schemes would like to thank all those who participated in the ICD-10 Implementation Task Team for giving their time in the development of the implementation plan. We would also like to ex tend our sincere thanks and appreciation
ICD-10 Implementation Review January 2004 - October 2006 National Task Team On ICD-10 Implementation October 2006 ACKNOWLEDGEMENTS The National Department of Health and the Council for Medical Schemes would like to thank all those who participated in the ICD-10 Implementation Task Team for giving their time in the development of the implementation plan. We would also like to ex tend our sincere thanks and appreciation
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Dental Therapy 2006pluscpix.pdf
Dental Therapy 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price
Dental Therapy 2007 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY DENTAL THERAPISTS EFFECTIVE FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service is equivalent to a specified percentage of the national health reference price
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Radiography 2006.pdf
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
Radiography 2006 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY RADIOGRAPHERS EFFECTIVE FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service is equivalent to a specified percentage of the national health reference price
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3rd_Draft_PMB_20090325.pdf
PMB review consultation document Third draft 2 5 March 2009 ii Contents List of f igures ................................ ................................ ................................ ..................... iii List of t ext boxes ................................ ................................ ................................ ............ iii List of a nnexures ................................ ................................ ................................ ............ iii List of a bbreviations ................................ ................................ ................................ .......
PMB review consultation document Third draft 2 5 March 2009 ii Contents List of f igures ................................ ................................ ................................ ..................... iii List of t ext boxes ................................ ................................ ................................ ............ iii List of a nnexures ................................ ................................ ................................ ............ iii List of a bbreviations ................................ ................................ ................................ .......
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IMSA - Elsabe Klinck.pdf
Innovative Medicines SA position statement and submission on the review of the Prescribed Minimum Benefits in response to the PMB Review process as initi ated by the Council for Medical Schemes APRIL 2008 For further information contact: Val Beaumont val@imsa.org.za / 011 880 4644 2 1. IMSAs view on the principles relating to the PMB Review IMSA understands that the law requires the review of the PMBs to lead to recommendations to revise the regulations to the Medical
Innovative Medicines SA position statement and submission on the review of the Prescribed Minimum Benefits in response to the PMB Review process as initi ated by the Council for Medical Schemes APRIL 2008 For further information contact: Val Beaumont val@imsa.org.za / 011 880 4644 2 1. IMSAs view on the principles relating to the PMB Review IMSA understands that the law requires the review of the PMBs to lead to recommendations to revise the regulations to the Medical
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Consolidated Regulatory Plan and Budget 2007_8.pdf
COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 2007/8 Page 2 of 98 STRATEGIC OBJECTIVES Secure an appropriate level of protecti on of beneficiaries o medical schemes and the public by authorizing the co nduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trus tees, beneficiaries and the public. Foster compliance with the Act by medical schemes, administrators and brokers
COUNCIL FOR MEDICAL SCHEMES REGULATORY PLAN AND BUDGET 2007/8 Page 2 of 98 STRATEGIC OBJECTIVES Secure an appropriate level of protecti on of beneficiaries o medical schemes and the public by authorizing the co nduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trus tees, beneficiaries and the public. Foster compliance with the Act by medical schemes, administrators and brokers
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REFsubmissions2008MainReport.pdf
\n\r ii TABLE OF CONTENTS EXECUTIVE SUMMARY.................................. ................................................... .....................IV1INTRODUCTION....................................... ................................................... ..........................11.1The REF shadow period 11.2Purpose of the report 12REF DATA AND METHODS: 2008 REF SUBMISSIONS......... ............................................12.1Case definitions and benchmarks 12.1.1Entry and verification criteria.................... ................................................... ..............12.1.22008 REF weighting table........................... ................................................... ............22.1.3Estimation of expected values (CDL benchmarks)..... ..............................................22.2REF data submitted for analysis 32.3Categorisation and the assessment of submitted data 32.3.1Categorisation..................................... ................................................... ....................42.3.2DIN scores......................................... ................................................... .....................72.3.3Evaluation of clinical credibility of submissions.. ................................................... ....72.3.4REF risk factors with deviations with significant f inancial impact............................112.3.5Evaluation of REF submissions by administrator..... ...............................................152.3.6REF price by age and community rate analyses....... ..............................................163THE POTENTIAL FINANCIAL IMPACT ON SCHEMES.......... ...........................................184CONCLUSIONS........................................ ................................................... ........................204.1Clinical credibility of submissions 204.2REF price by age and community rate analysis 204.3Potential financial impact on schemes 20LIST OF FIGURES
\n\r ii TABLE OF CONTENTS EXECUTIVE SUMMARY.................................. ................................................... .....................IV1INTRODUCTION....................................... ................................................... ..........................11.1The REF shadow period 11.2Purpose of the report 12REF DATA AND METHODS: 2008 REF SUBMISSIONS......... ............................................12.1Case definitions and benchmarks 12.1.1Entry and verification criteria.................... ................................................... ..............12.1.22008 REF weighting table........................... ................................................... ............22.1.3Estimation of expected values (CDL benchmarks)..... ..............................................22.2REF data submitted for analysis 32.3Categorisation and the assessment of submitted data 32.3.1Categorisation..................................... ................................................... ....................42.3.2DIN scores......................................... ................................................... .....................72.3.3Evaluation of clinical credibility of submissions.. ................................................... ....72.3.4REF risk factors with deviations with significant f inancial impact............................112.3.5Evaluation of REF submissions by administrator..... ...............................................152.3.6REF price by age and community rate analyses....... ..............................................163THE POTENTIAL FINANCIAL IMPACT ON SCHEMES.......... ...........................................184CONCLUSIONS........................................ ................................................... ........................204.1Clinical credibility of submissions 204.2REF price by age and community rate analysis 204.3Potential financial impact on schemes 20LIST OF FIGURES
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ICD Coding Standards Vers 2 June 08.pdf
The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. South African ICD-10 Coding Standards Developed to assist the clinical code r in the South African environment The South African ICD-10 Coding St andards, Version 2 (as at June 2008) Compiled by the National Task Team for the Implementation of ICD-10 The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. The South African ICD-10 Coding St andards,
The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. South African ICD-10 Coding Standards Developed to assist the clinical code r in the South African environment The South African ICD-10 Coding St andards, Version 2 (as at June 2008) Compiled by the National Task Team for the Implementation of ICD-10 The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. The South African ICD-10 Coding St andards,
Weighting score:0.0769239
RegulatoryPlanandBudget2004_5.pdf
Contents Council For Medical Schemes Regulatory plan and budget 2004/5 Financial Year Page 2 of 64 Part 1. Strategic review for April 2004 March 2005 Part 3: Budget for 2004/2005 1. Introduction 1. Full budget 2. Maintaining legitimacy of the Council for Medical Schemes 2. Income budget 2004 / 2005 3. Fair Treatment of beneficiaries 3. Budget per unit 4. Theme Projects for 2004 / 05
Contents Council For Medical Schemes Regulatory plan and budget 2004/5 Financial Year Page 2 of 64 Part 1. Strategic review for April 2004 March 2005 Part 3: Budget for 2004/2005 1. Introduction 1. Full budget 2. Maintaining legitimacy of the Council for Medical Schemes 2. Income budget 2004 / 2005 3. Fair Treatment of beneficiaries 3. Budget per unit 4. Theme Projects for 2004 / 05
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REFSubmissions2009_20100831.pdf
The analysis of REF shadow returns 200 9 1 5 August 20 1 0
The analysis of REF shadow returns 200 9 1 5 August 20 1 0
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Circular_10_of_2006_Version_release.pdf
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
P h one: +27 ( 0 ) 12 431-0500 Fax : +27 ( 0 ) 1 2 430-7644 P r ivate Bag X3 4, HAT F IE LD, 0028 Hadefields Block E, 1267 P r etorius Stree t , HAT F IELD
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CMS_NEWS_June_2007.pdf
June 2007 June 2007CMSNEWS Newsletter of the Council For Medical Schemes CMS News Interviews Professor William Pick CMS News Interviews Professor William Pick CONTENTS CMS NEWS INTERVIEWS PROFESSOR WILLIAM PICK 2007 BENEFITS AND CONTRIBUTION ANALYSIS MEDICAL SCHEMES ACT TO GET A FACE LIFT COUNCIL FACILITATES TALKS BETWEEN FUNDERS AND PROVIDERS CMS HOLDS HEALTHCARE PROVIDERS INFORMATION SESSIONS PROSANOS JOURNEY TO CURATORSHIP TURNED DOWN BENEFITS LEAD TO A COURT BATTLE WORKSHOP ON GUIDELINES TO ENTRY AND VERIFICATION CRITERIA GIVES REF THUMBS UP CONFLICT OF INTEREST BROKER ACCREDITATION REF ON TRACK CONSUMER CORNER 01 02 03 04 05 06 07 08 08 10 10 12 Somehow, the CMS News failed to make the regular appearance it was originally intended to make. We would like to change that, and commit ourselves to putting this publication out
June 2007 June 2007CMSNEWS Newsletter of the Council For Medical Schemes CMS News Interviews Professor William Pick CMS News Interviews Professor William Pick CONTENTS CMS NEWS INTERVIEWS PROFESSOR WILLIAM PICK 2007 BENEFITS AND CONTRIBUTION ANALYSIS MEDICAL SCHEMES ACT TO GET A FACE LIFT COUNCIL FACILITATES TALKS BETWEEN FUNDERS AND PROVIDERS CMS HOLDS HEALTHCARE PROVIDERS INFORMATION SESSIONS PROSANOS JOURNEY TO CURATORSHIP TURNED DOWN BENEFITS LEAD TO A COURT BATTLE WORKSHOP ON GUIDELINES TO ENTRY AND VERIFICATION CRITERIA GIVES REF THUMBS UP CONFLICT OF INTEREST BROKER ACCREDITATION REF ON TRACK CONSUMER CORNER 01 02 03 04 05 06 07 08 08 10 10 12 Somehow, the CMS News failed to make the regular appearance it was originally intended to make. We would like to change that, and commit ourselves to putting this publication out
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Regulatory Plan 2005-2006.pdf
COUNCILFORMEDICALSCHEMESREGULATORY PLAN AND BUDGET 2005/6 COUNCILFORMEDICALSCHEMES COUNCILFORMEDICALSCHEMES1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 T elephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.com COUNCILFORMEDICALSCHEMES STRATEGIC OBJECTIVESSecure an appropriate level of protection for beneficiaries of medical schemes and the public by authorising the conduct of medical schemes business and monitoring the financial performance and soundness of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees,beneficiaries and the public. F oster compliance with the Act by medical schemes, administrators and brokers and initiate enforcement action where required. Investigate and resolve complaints raised by beneficiaries and the public. Monitor the impact of the Act,research developments,and r ecommend policy options to improve
COUNCILFORMEDICALSCHEMESREGULATORY PLAN AND BUDGET 2005/6 COUNCILFORMEDICALSCHEMES COUNCILFORMEDICALSCHEMES1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 T elephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.com COUNCILFORMEDICALSCHEMES STRATEGIC OBJECTIVESSecure an appropriate level of protection for beneficiaries of medical schemes and the public by authorising the conduct of medical schemes business and monitoring the financial performance and soundness of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees,beneficiaries and the public. F oster compliance with the Act by medical schemes, administrators and brokers and initiate enforcement action where required. Investigate and resolve complaints raised by beneficiaries and the public. Monitor the impact of the Act,research developments,and r ecommend policy options to improve
Weighting score:0.07536972
PMB_ConsumerGuideBookLet.pdf
Prescribed Minimum Benefits and Chronic Medication Prescribed Minimum Benefits and Chronic Medication 2 Abbreviations used: PMBs # 3Prescribed Minimum Benefits and Chronic Medication Is it true that schemes now also have to provide
Prescribed Minimum Benefits and Chronic Medication Prescribed Minimum Benefits and Chronic Medication 2 Abbreviations used: PMBs # 3Prescribed Minimum Benefits and Chronic Medication Is it true that schemes now also have to provide
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GFPBP_ReinsuranceTheMedicalSchemesAct.pdf
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Schemes Act 131 of 1998, as amended. February 20 11 Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Schemes Act 131 of 1998, as amended. February 20 11 Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical
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GFPBP_ReinsuranceTheMedicalSchemesAct_20090916.pdf
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Schemes Act 131 of 1998, as amended. September 2009 Guideline to trustees for the submission of reinsurance contracts to the Registrar
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Schemes Act 131 of 1998, as amended. September 2009 Guideline to trustees for the submission of reinsurance contracts to the Registrar
Weighting score:0.07105926
GuidelinePrepOfBusinessPlanPursuantSubmissioReinsurance.pdf
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Sche mes Act 131 of 1998, as amended February 20 12 Guideline to trustees for the submission of reinsurance contracts to the Registrar
Guideline to trustees for the submission of reinsurance contracts to the Registrar of Medical Schemes in terms of Section 20 of the Medical Sche mes Act 131 of 1998, as amended February 20 12 Guideline to trustees for the submission of reinsurance contracts to the Registrar
Weighting score:0.07105926
Med_Council_Appeal_Genesis.pdf
1 THE COUNCIL FOR MEDICAL SCHEMES APPEAL COMMITTEE In the matter between: GENESIS MEDICAL SCHEME Appellant and REGISTRAR OF MEDICAL SCHEMES Respondent ________________________ _____________________ ________________ _______ APPEAL RULING ________________________ _____________________ ________________ _______ 1. The appellant, Genesis Medical Scheme, has appealed in terms of section 49(1) of the Medical Schemes Act, 131 of 1998 ("the Act") against a ruling of the respondent, the Registrar of Medical Schemes, in terms of which the respondent
1 THE COUNCIL FOR MEDICAL SCHEMES APPEAL COMMITTEE In the matter between: GENESIS MEDICAL SCHEME Appellant and REGISTRAR OF MEDICAL SCHEMES Respondent ________________________ _____________________ ________________ _______ APPEAL RULING ________________________ _____________________ ________________ _______ 1. The appellant, Genesis Medical Scheme, has appealed in terms of section 49(1) of the Medical Schemes Act, 131 of 1998 ("the Act") against a ruling of the respondent, the Registrar of Medical Schemes, in terms of which the respondent
Weighting score:0.07105926
POPIAct.pdf
REPUBLICOFSOUTHAFRICA PROTECTIONOFPERSONAL INFORMATIONBILL (AspresentedbythePortfolioCommitteeonJusticeandConstitutionalDevelopment (NationalAssembly),afterconsiderationoftheProtectionofPersonalInformationBill [B9\2272009]) (TheEnglishtextistheoff\031cialtextoftheBill) (M INISTEROFJ USTICEANDC ONSTITUTIONAL D EVELOPMENT ) [B9B\2272009]ISBN978-1-77037-998-5No.ofcopiesprinted....................................1800 GENERALEXPLANATORYNOTE: [ ] Wordsinboldtypeinsquarebracketsindicateomissionsfrom existingenactments. Wordsunderlinedwithasolidlineindicateinsertionsin existingenactments. BILL Topromotetheprotectionofpersonalinformationprocessedbypublicandprivate bodies;tointroducecertainconditionssoastoestablishminimumrequirements fortheprocessingofpersonalinformation;toprovidefortheestablishmentofan InformationRegulatortoexercisecertainpowersandtoperformcertainduties andfunctionsintermsofthisActandthePromotionofAccesstoInformationAct, 2000;toprovidefortheissuingofcodesofconduct;toprovidefortherightsof personsregardingunsolicitedelectroniccommunicationsandautomateddecision making;toregulatethe\037owofpersonalinformationacrossthebordersofthe Republic;andtoprovideformattersconnectedtherewith. PREAMBLE RECOGNISINGTHAT \227 \002 section14oftheConstitutionoftheRepublicofSouthAfrica,1996,providesthat everyonehastherighttoprivacy;\002 therighttoprivacyincludesarighttoprotectionagainsttheunlawfulcollection, retention,disseminationanduseofpersonalinformation;\002 theStatemustrespect,protect,promoteandful\036ltherightsintheBillofRights; ANDBEARINGINMINDTHAT \227 \002 consonantwiththeconstitutionalvaluesofdemocracyandopenness,theneedfor economicandsocialprogress,withintheframeworkoftheinformationsociety, requirestheremovalofunnecessaryimpedimentstothefree\037owofinformation, includingpersonalinformation; ANDINORDERTO \227 \002 regulate,inharmonywithinternationalstandards,theprocessingofpersonal informationbypublicandprivatebodiesinamannerthatgiveseffecttotheright toprivacysubjecttojusti\036ablelimitationsthatareaimedatprotectingotherrights andimportantinterests, P arliamentoftheRepublicofSouthAfricathereforeenactsasfollows:\227 CONTENTSOFACT CHAPTER1 DEFINITIONSANDPURPOSE 1.De\036nitions 2.PurposeofAct CHAPTER2 APPLICATIONPROVISIONS 3.ApplicationandinterpretationofAct 4.Lawfulprocessingofpersonalinformation 5.Rightsofdatasubjects 6.Exclusions 7.Exclusionforjournalistic,literaryorartisticpurposes CHAPTER3 CONDITIONSFORLAWFULPROCESSINGOFPERSONALINFORMATION PartA Processingofpersonalinformationingeneral Condition1 Accountability 8.Responsiblepartytoensureconditionsforlawfulprocessing Condition2 Processinglimitation 9.Lawfulnessofprocessing 10.Minimality 11.Consent,justi\036cationandobjection 12.Collectiondirectlyfromdatasubject Condition3 Purposespeci\036cation 13.Collectionforspeci\036cpurpose 14.Retentionandrestrictionofrecords Condition4 Furtherprocessinglimitation 15.Furtherprocessingtobecompatiblewithpurposeofcollection Condition5 Informationquality 16.Qualityofinformation 3 5 10 15 20 25 30 35 Condition6 Openness 17.Documentation 18.Noti\036cationtodatasubjectwhencollectingpersonalinformation Condition7 Securitysafeguards 19.Securitymeasuresonintegrityofpersonalinformation 20.Informationprocessedbyoperatororpersonactingunderauthority 21.Securitymeasuresregardinginformationprocessedbyoperator 22.Noti\036cationofsecuritycompromises Condition8 Datasubjectparticipation 23.Accesstopersonalinformation 24.Correctionofpersonalinformation 25.Mannerofaccess PartB Processingofspecialpersonalinformation 26.Prohibitiononprocessingofspecialpersonalinformation 27.Generalauthorisationconcerningspecialpersonalinformation 28.Authorisationconcerningdatasubject'sreligiousorphilosophicalbeliefs 29.Authorisationconcerningdatasubject'sraceorethnicorigin 30.Authorisationconcerningdatasubject'stradeunionmembership 31.Authorisationconcerningdatasubject'spoliticalpersuasion 32.Authorisationconcerningdatasubject'shealthorsexlife 33.Authorisationconcerningdatasubject'scriminalbehaviour PartC Processingofpersonalinformationofchildren 34.Prohibitiononprocessingpersonalinformationofchildren 35.Generalauthorisationconcerningpersonalinformationofchildren CHAPTER4 EXEMPTIONFROMCONDITIONSFORPROCESSINGOF PERSONALINFORMATION 36.General 37.Regulatormayexemptprocessingofpersonalinformation 38.Exemptioninrespectofcertainfunctions CHAPTER5 SUPERVISION PartA InformationRegulator 39.EstablishmentofInformationRegulator 40.Powers,dutiesandfunctionsofRegulator 4 5 10 15 20 25 30 35 40 41.Appointment,termofofficeandremovalofmembersofRegulator 42.Vacancies 43.Powers,dutiesandfunctionsofChairpersonandothermembers 44.Regulatortohaveregardtocertainmatters 45.Con\037ictofinterest 46.Remuneration,allowances,bene\036tsandprivilegesofmembers 47.Staff 48.Powers,dutiesandfunctionsofchiefexecutiveofficer 49.CommitteesofRegulator 50.EstablishmentofEnforcementCommittee 51.MeetingsofRegulator 52.Funds 53.ProtectionofRegulator 54.Dutyofcon\036dentiality PartB InformationOfficer 55.DutiesandresponsibilitiesofInformationOfficer 56.Designationanddelegationofdeputyinformationofficers CHAPTER6 PRIORAUTHORISATION PriorAuthorisation 57.Processingsubjecttopriorauthorisation 58.ResponsiblepartytonotifyRegulatorifprocessingissubjecttoprior authorisation 59.Failuretonotifyprocessingsubjecttopriorauthorisation CHAPTER7 CODESOFCONDUCT 60.Issuingofcodesofconduct 61.Processforissuingcodesofconduct 62.Noti\036cation,availabilityandcommencementofcodeofconduct 63.Procedurefordealingwithcomplaints 64.Amendmentandrevocationofcodesofconduct 65.Guidelinesaboutcodesofconduct 66.Registerofapprovedcodesofconduct 67.Reviewofoperationofapprovedcodeofconduct 68.Effectoffailuretocomplywithcodeofconduct CHAPTER8 RIGHTSOFDATASUBJECTSREGARDINGDIRECTMARKETING BYMEANSOFUNSOLICITEDELECTRONICCOMMUNICATIONS, DIRECTORIESANDAUTOMATEDDECISIONMAKING 69.Directmarketingbymeansofunsolicitedelectroniccommunications 70.Directories 71.Automateddecisionmaking CHAPTER9 TRANSBORDERINFORMATIONFLOWS 72.TransfersofpersonalinformationoutsideRepublic 5 5 10 15 20 25 30 35 40 45 CHAPTER10 ENFORCEMENT 73.Interferencewithprotectionofpersonalinformationofdatasubject 74.Complaints 75.ModeofcomplaintstoRegulator 76.Actiononreceiptofcomplaint 77.Regulatormaydecidetotakenoactiononcomplaint 78.Referralofcomplainttoregulatorybody 79.Pre-investigationproceedingsofRegulator 80.Settlementofcomplaints 81.InvestigationproceedingsofRegulator 82.Issueofwarrants 83.Requirementsforissuingofwarrant 84.Executionofwarrants 85.Mattersexemptfromsearchandseizure 86.Communicationbetweenlegaladviserandclientexempt 87.Objectiontosearchandseizure 88.Returnofwarrants 89.Assessment 90.Informationnotice 91.Partiestobeinformedofresultofassessment 92.MattersreferredtoEnforcementCommittee 93.FunctionsofEnforcementCommittee 94.Partiestobeinformedofdevelopmentsduringandresultofinvestigation 95.Enforcementnotice 96.Cancellationofenforcementnotice 97.Rightofappeal 98.Considerationofappeal 99.Civilremedies CHAPTER11 OFFENCES,PENALTIESANDADMINISTRATIVEFINES 100.ObstructionofRegulator 101.Breachofcon\036dentiality 102.Obstructionofexecutionofwarrant 103.Failuretocomplywithenforcementorinformationnotices 104.Offencesbywitnesses 105.Unlawfulactsbyresponsiblepartyinconnectionwithaccountnumber 106.Unlawfulactsbythirdpartiesinconnectionwithaccountnumber 107.Penalties 108.Magistrate'sCourtjurisdictiontoimposepenalties 109.Administrative\036nes CHAPTER12 GENERALPROVISIONS 110.Amendmentoflaws 111.Fees 112.Regulations 113.Procedureformakingregulations 114.Transitionalarrangements 115.Shorttitleandcommencement SCHEDULE Lawsamendedbysection110 6 5 10 15 20 25 30 35 40 45 50 CHAPTER1 DEFINITIONSANDPURPOSE De\036nitions 1. InthisAct,unlessthecontextindicatesotherwise\227 ''biometrics'' meansatechniqueofpersonalidenti\036cationthatisbasedon physical,physiologicalorbehaviouralcharacterisationincludingbloodtyping, \036ngerprinting,DNAanalysis,retinalscanningandvoicerecognition; ''child'' meansanaturalpersonundertheageof18yearswhoisnotlegally competent,withouttheassistanceofacompetentperson,totakeanyactionor decisioninrespectofanymatterconcerninghim-orherself; ''codeofconduct'' meansacodeofconductissuedintermsofChapter7; ''consent'' meansanyvoluntary,speci\036candinformedexpressionofwillinterms ofwhichpermissionisgivenfortheprocessingofpersonalinformation; ''Constitution'' meanstheConstitutionoftheRepublicofSouthAfrica,1996; ''competentperson'' meansanypersonwhoislegallycompetenttoconsenttoany actionordecisionbeingtakeninrespectofanymatterconcerningachild; ''datasubject'' meansthepersontowhompersonalinformationrelates; ''de-identify'',inrelationtopersonalinformationofadatasubject,meanstodelete anyinformationthat\227 (a) identi\036esthedatasubject; (b) canbeusedormanipulatedbyareasonablyforeseeablemethodtoidentifythe datasubject;or (c) canbelinkedbyareasonablyforeseeablemethodtootherinformationthat identi\036esthedatasubject, and ''de-identi\036ed'' hasacorrespondingmeaning; ''directmarketing'' meanstoapproachadatasubject,eitherinpersonorbymail orelectroniccommunication,forthedirectorindirectpurposeof\227 (a) promotingorofferingtosupply,intheordinarycourseofbusiness,anygoods orservicestothedatasubject;or (b) requestingthedatasubjecttomakeadonationofanykindforanyreason; ''electroniccommunication'' meansanytext,voice,soundorimagemessagesent overanelectroniccommunicationsnetworkwhichisstoredinthenetworkorinthe recipient'sterminalequipmentuntilitiscollectedbytherecipient; ''enforcementnotice'' meansanoticeissuedintermsofsection95; ''\036lingsystem'' meansanystructuredsetofpersonalinformation,whether centralised,decentralisedordispersedonafunctionalorgeographicalbasis,which isaccessibleaccordingtospeci\036ccriteria; ''informationmatchingprogramme'' meansthecomparison,whethermanually orbymeansofanyelectronicorotherdevice,ofanydocumentthatcontains personalinformationabouttenormoredatasubjectswithoneormoredocuments thatcontainpersonalinformationoftenormoredatasubjects,forthepurposeof producingorverifyinginformationthatmaybeusedforthepurposeoftakingany actioninregardtoanidenti\036abledatasubject; ''informationofficer'' of,orinrelationto,a\227 (a) publicbodymeansaninformationofficerordeputyinformationofficeras contemplatedintermsofsection1or17;or (b) privatebodymeanstheheadofaprivatebodyascontemplatedinsection1, ofthePromotionofAccesstoInformationAct; ''Minister'' meanstheCabinetmemberresponsiblefortheadministrationof justice; ''operator'' meansapersonwhoprocessespersonalinformationforaresponsible partyintermsofacontractormandate,withoutcomingunderthedirectauthority ofthatparty; ''person'' meansanaturalpersonorajuristicperson; ''personalinformation'' meansinformationrelatingtoanidenti\036able,living, naturalperson,andwhereitisapplicable,anidenti\036able,existingjuristicperson, including,butnotlimitedto\227 (a) informationrelatingtotherace,gender,sex,pregnancy,maritalstatus, national,ethnicorsocialorigin,colour,sexualorientation,age,physicalor 7 5 10 15 20 25 30 35 40 45 50 55 mentalhealth,well-being,disability,religion,conscience,belief,culture, languageandbirthoftheperson; (b)
REPUBLICOFSOUTHAFRICA PROTECTIONOFPERSONAL INFORMATIONBILL (AspresentedbythePortfolioCommitteeonJusticeandConstitutionalDevelopment (NationalAssembly),afterconsiderationoftheProtectionofPersonalInformationBill [B9\2272009]) (TheEnglishtextistheoff\031cialtextoftheBill) (M INISTEROFJ USTICEANDC ONSTITUTIONAL D EVELOPMENT ) [B9B\2272009]ISBN978-1-77037-998-5No.ofcopiesprinted....................................1800 GENERALEXPLANATORYNOTE: [ ] Wordsinboldtypeinsquarebracketsindicateomissionsfrom existingenactments. Wordsunderlinedwithasolidlineindicateinsertionsin existingenactments. BILL Topromotetheprotectionofpersonalinformationprocessedbypublicandprivate bodies;tointroducecertainconditionssoastoestablishminimumrequirements fortheprocessingofpersonalinformation;toprovidefortheestablishmentofan InformationRegulatortoexercisecertainpowersandtoperformcertainduties andfunctionsintermsofthisActandthePromotionofAccesstoInformationAct, 2000;toprovidefortheissuingofcodesofconduct;toprovidefortherightsof personsregardingunsolicitedelectroniccommunicationsandautomateddecision making;toregulatethe\037owofpersonalinformationacrossthebordersofthe Republic;andtoprovideformattersconnectedtherewith. PREAMBLE RECOGNISINGTHAT \227 \002 section14oftheConstitutionoftheRepublicofSouthAfrica,1996,providesthat everyonehastherighttoprivacy;\002 therighttoprivacyincludesarighttoprotectionagainsttheunlawfulcollection, retention,disseminationanduseofpersonalinformation;\002 theStatemustrespect,protect,promoteandful\036ltherightsintheBillofRights; ANDBEARINGINMINDTHAT \227 \002 consonantwiththeconstitutionalvaluesofdemocracyandopenness,theneedfor economicandsocialprogress,withintheframeworkoftheinformationsociety, requirestheremovalofunnecessaryimpedimentstothefree\037owofinformation, includingpersonalinformation; ANDINORDERTO \227 \002 regulate,inharmonywithinternationalstandards,theprocessingofpersonal informationbypublicandprivatebodiesinamannerthatgiveseffecttotheright toprivacysubjecttojusti\036ablelimitationsthatareaimedatprotectingotherrights andimportantinterests, P arliamentoftheRepublicofSouthAfricathereforeenactsasfollows:\227 CONTENTSOFACT CHAPTER1 DEFINITIONSANDPURPOSE 1.De\036nitions 2.PurposeofAct CHAPTER2 APPLICATIONPROVISIONS 3.ApplicationandinterpretationofAct 4.Lawfulprocessingofpersonalinformation 5.Rightsofdatasubjects 6.Exclusions 7.Exclusionforjournalistic,literaryorartisticpurposes CHAPTER3 CONDITIONSFORLAWFULPROCESSINGOFPERSONALINFORMATION PartA Processingofpersonalinformationingeneral Condition1 Accountability 8.Responsiblepartytoensureconditionsforlawfulprocessing Condition2 Processinglimitation 9.Lawfulnessofprocessing 10.Minimality 11.Consent,justi\036cationandobjection 12.Collectiondirectlyfromdatasubject Condition3 Purposespeci\036cation 13.Collectionforspeci\036cpurpose 14.Retentionandrestrictionofrecords Condition4 Furtherprocessinglimitation 15.Furtherprocessingtobecompatiblewithpurposeofcollection Condition5 Informationquality 16.Qualityofinformation 3 5 10 15 20 25 30 35 Condition6 Openness 17.Documentation 18.Noti\036cationtodatasubjectwhencollectingpersonalinformation Condition7 Securitysafeguards 19.Securitymeasuresonintegrityofpersonalinformation 20.Informationprocessedbyoperatororpersonactingunderauthority 21.Securitymeasuresregardinginformationprocessedbyoperator 22.Noti\036cationofsecuritycompromises Condition8 Datasubjectparticipation 23.Accesstopersonalinformation 24.Correctionofpersonalinformation 25.Mannerofaccess PartB Processingofspecialpersonalinformation 26.Prohibitiononprocessingofspecialpersonalinformation 27.Generalauthorisationconcerningspecialpersonalinformation 28.Authorisationconcerningdatasubject'sreligiousorphilosophicalbeliefs 29.Authorisationconcerningdatasubject'sraceorethnicorigin 30.Authorisationconcerningdatasubject'stradeunionmembership 31.Authorisationconcerningdatasubject'spoliticalpersuasion 32.Authorisationconcerningdatasubject'shealthorsexlife 33.Authorisationconcerningdatasubject'scriminalbehaviour PartC Processingofpersonalinformationofchildren 34.Prohibitiononprocessingpersonalinformationofchildren 35.Generalauthorisationconcerningpersonalinformationofchildren CHAPTER4 EXEMPTIONFROMCONDITIONSFORPROCESSINGOF PERSONALINFORMATION 36.General 37.Regulatormayexemptprocessingofpersonalinformation 38.Exemptioninrespectofcertainfunctions CHAPTER5 SUPERVISION PartA InformationRegulator 39.EstablishmentofInformationRegulator 40.Powers,dutiesandfunctionsofRegulator 4 5 10 15 20 25 30 35 40 41.Appointment,termofofficeandremovalofmembersofRegulator 42.Vacancies 43.Powers,dutiesandfunctionsofChairpersonandothermembers 44.Regulatortohaveregardtocertainmatters 45.Con\037ictofinterest 46.Remuneration,allowances,bene\036tsandprivilegesofmembers 47.Staff 48.Powers,dutiesandfunctionsofchiefexecutiveofficer 49.CommitteesofRegulator 50.EstablishmentofEnforcementCommittee 51.MeetingsofRegulator 52.Funds 53.ProtectionofRegulator 54.Dutyofcon\036dentiality PartB InformationOfficer 55.DutiesandresponsibilitiesofInformationOfficer 56.Designationanddelegationofdeputyinformationofficers CHAPTER6 PRIORAUTHORISATION PriorAuthorisation 57.Processingsubjecttopriorauthorisation 58.ResponsiblepartytonotifyRegulatorifprocessingissubjecttoprior authorisation 59.Failuretonotifyprocessingsubjecttopriorauthorisation CHAPTER7 CODESOFCONDUCT 60.Issuingofcodesofconduct 61.Processforissuingcodesofconduct 62.Noti\036cation,availabilityandcommencementofcodeofconduct 63.Procedurefordealingwithcomplaints 64.Amendmentandrevocationofcodesofconduct 65.Guidelinesaboutcodesofconduct 66.Registerofapprovedcodesofconduct 67.Reviewofoperationofapprovedcodeofconduct 68.Effectoffailuretocomplywithcodeofconduct CHAPTER8 RIGHTSOFDATASUBJECTSREGARDINGDIRECTMARKETING BYMEANSOFUNSOLICITEDELECTRONICCOMMUNICATIONS, DIRECTORIESANDAUTOMATEDDECISIONMAKING 69.Directmarketingbymeansofunsolicitedelectroniccommunications 70.Directories 71.Automateddecisionmaking CHAPTER9 TRANSBORDERINFORMATIONFLOWS 72.TransfersofpersonalinformationoutsideRepublic 5 5 10 15 20 25 30 35 40 45 CHAPTER10 ENFORCEMENT 73.Interferencewithprotectionofpersonalinformationofdatasubject 74.Complaints 75.ModeofcomplaintstoRegulator 76.Actiononreceiptofcomplaint 77.Regulatormaydecidetotakenoactiononcomplaint 78.Referralofcomplainttoregulatorybody 79.Pre-investigationproceedingsofRegulator 80.Settlementofcomplaints 81.InvestigationproceedingsofRegulator 82.Issueofwarrants 83.Requirementsforissuingofwarrant 84.Executionofwarrants 85.Mattersexemptfromsearchandseizure 86.Communicationbetweenlegaladviserandclientexempt 87.Objectiontosearchandseizure 88.Returnofwarrants 89.Assessment 90.Informationnotice 91.Partiestobeinformedofresultofassessment 92.MattersreferredtoEnforcementCommittee 93.FunctionsofEnforcementCommittee 94.Partiestobeinformedofdevelopmentsduringandresultofinvestigation 95.Enforcementnotice 96.Cancellationofenforcementnotice 97.Rightofappeal 98.Considerationofappeal 99.Civilremedies CHAPTER11 OFFENCES,PENALTIESANDADMINISTRATIVEFINES 100.ObstructionofRegulator 101.Breachofcon\036dentiality 102.Obstructionofexecutionofwarrant 103.Failuretocomplywithenforcementorinformationnotices 104.Offencesbywitnesses 105.Unlawfulactsbyresponsiblepartyinconnectionwithaccountnumber 106.Unlawfulactsbythirdpartiesinconnectionwithaccountnumber 107.Penalties 108.Magistrate'sCourtjurisdictiontoimposepenalties 109.Administrative\036nes CHAPTER12 GENERALPROVISIONS 110.Amendmentoflaws 111.Fees 112.Regulations 113.Procedureformakingregulations 114.Transitionalarrangements 115.Shorttitleandcommencement SCHEDULE Lawsamendedbysection110 6 5 10 15 20 25 30 35 40 45 50 CHAPTER1 DEFINITIONSANDPURPOSE De\036nitions 1. InthisAct,unlessthecontextindicatesotherwise\227 ''biometrics'' meansatechniqueofpersonalidenti\036cationthatisbasedon physical,physiologicalorbehaviouralcharacterisationincludingbloodtyping, \036ngerprinting,DNAanalysis,retinalscanningandvoicerecognition; ''child'' meansanaturalpersonundertheageof18yearswhoisnotlegally competent,withouttheassistanceofacompetentperson,totakeanyactionor decisioninrespectofanymatterconcerninghim-orherself; ''codeofconduct'' meansacodeofconductissuedintermsofChapter7; ''consent'' meansanyvoluntary,speci\036candinformedexpressionofwillinterms ofwhichpermissionisgivenfortheprocessingofpersonalinformation; ''Constitution'' meanstheConstitutionoftheRepublicofSouthAfrica,1996; ''competentperson'' meansanypersonwhoislegallycompetenttoconsenttoany actionordecisionbeingtakeninrespectofanymatterconcerningachild; ''datasubject'' meansthepersontowhompersonalinformationrelates; ''de-identify'',inrelationtopersonalinformationofadatasubject,meanstodelete anyinformationthat\227 (a) identi\036esthedatasubject; (b) canbeusedormanipulatedbyareasonablyforeseeablemethodtoidentifythe datasubject;or (c) canbelinkedbyareasonablyforeseeablemethodtootherinformationthat identi\036esthedatasubject, and ''de-identi\036ed'' hasacorrespondingmeaning; ''directmarketing'' meanstoapproachadatasubject,eitherinpersonorbymail orelectroniccommunication,forthedirectorindirectpurposeof\227 (a) promotingorofferingtosupply,intheordinarycourseofbusiness,anygoods orservicestothedatasubject;or (b) requestingthedatasubjecttomakeadonationofanykindforanyreason; ''electroniccommunication'' meansanytext,voice,soundorimagemessagesent overanelectroniccommunicationsnetworkwhichisstoredinthenetworkorinthe recipient'sterminalequipmentuntilitiscollectedbytherecipient; ''enforcementnotice'' meansanoticeissuedintermsofsection95; ''\036lingsystem'' meansanystructuredsetofpersonalinformation,whether centralised,decentralisedordispersedonafunctionalorgeographicalbasis,which isaccessibleaccordingtospeci\036ccriteria; ''informationmatchingprogramme'' meansthecomparison,whethermanually orbymeansofanyelectronicorotherdevice,ofanydocumentthatcontains personalinformationabouttenormoredatasubjectswithoneormoredocuments thatcontainpersonalinformationoftenormoredatasubjects,forthepurposeof producingorverifyinginformationthatmaybeusedforthepurposeoftakingany actioninregardtoanidenti\036abledatasubject; ''informationofficer'' of,orinrelationto,a\227 (a) publicbodymeansaninformationofficerordeputyinformationofficeras contemplatedintermsofsection1or17;or (b) privatebodymeanstheheadofaprivatebodyascontemplatedinsection1, ofthePromotionofAccesstoInformationAct; ''Minister'' meanstheCabinetmemberresponsiblefortheadministrationof justice; ''operator'' meansapersonwhoprocessespersonalinformationforaresponsible partyintermsofacontractormandate,withoutcomingunderthedirectauthority ofthatparty; ''person'' meansanaturalpersonorajuristicperson; ''personalinformation'' meansinformationrelatingtoanidenti\036able,living, naturalperson,andwhereitisapplicable,anidenti\036able,existingjuristicperson, including,butnotlimitedto\227 (a) informationrelatingtotherace,gender,sex,pregnancy,maritalstatus, national,ethnicorsocialorigin,colour,sexualorientation,age,physicalor 7 5 10 15 20 25 30 35 40 45 50 55 mentalhealth,well-being,disability,religion,conscience,belief,culture, languageandbirthoftheperson; (b)
Weighting score:0.0628081
AR2012_2013HR.pdf
COUNCIL FOR MEDICAL SCHEMES Annual Report 2012- 2013 { the es sense of life } CONTENTS Chapter 1: Council for Medical Schemes 1 April 2012 to 31 March 2013 Part A: General information General information of the Council for Medical Schemes Glossary, acronyms, and abbreviations List of Tables List of Figures List of Annexures Strategic overview Legislative and other mandates Organisational structure Statement of the Chairperson of Council Overview of the Chief Executive & Registrar Part B: Performance information Statement of responsibility for performance information Performance information by Programme (Unit) Part D: Human Resources
COUNCIL FOR MEDICAL SCHEMES Annual Report 2012- 2013 { the es sense of life } CONTENTS Chapter 1: Council for Medical Schemes 1 April 2012 to 31 March 2013 Part A: General information General information of the Council for Medical Schemes Glossary, acronyms, and abbreviations List of Tables List of Figures List of Annexures Strategic overview Legislative and other mandates Organisational structure Statement of the Chairperson of Council Overview of the Chief Executive & Registrar Part B: Performance information Statement of responsibility for performance information Performance information by Programme (Unit) Part D: Human Resources
Weighting score:0.0628081
AR2013_2014HR.pdf
CMS Council for Medical Schemes ANNUAL REPORT 2013/14 PROTECTING THE INTERESTS OF MEMBERS PROMOTING AN ACCOUNTABLE INDUSTRY ANNUAL REPORT COUNCIL FOR MEDICAL SCHEMES RP91/2014 ISBN: 978-0-620-60270-9 Council for Medical Schemes T 012 431 0500 F 012 431 7644 E information@medicalschemes.com www.medicalschemes.com ANNUAL REPORT 2013/2014 1 Contents Annual Report of the Council of Medical Schemes 2013/14 Part A: General Information General information 6 List of tables 13 List of annexures 17 Report of the Chairperson of Council 29 Part B:
CMS Council for Medical Schemes ANNUAL REPORT 2013/14 PROTECTING THE INTERESTS OF MEMBERS PROMOTING AN ACCOUNTABLE INDUSTRY ANNUAL REPORT COUNCIL FOR MEDICAL SCHEMES RP91/2014 ISBN: 978-0-620-60270-9 Council for Medical Schemes T 012 431 0500 F 012 431 7644 E information@medicalschemes.com www.medicalschemes.com ANNUAL REPORT 2013/2014 1 Contents Annual Report of the Council of Medical Schemes 2013/14 Part A: General Information General information 6 List of tables 13 List of annexures 17 Report of the Chairperson of Council 29 Part B:
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AR2013_2014LR.pdf
CMS Councilfor Medical Schemes ANNUAL REPORT 2013/14PROTECTING THE INTERESTS OF MEMBERS PROMOTING AN ACCOUNTABLE INDUSTRY ANNUAL REPORT COUNCIL FOR MEDICAL SCHEMESRP91/2014 ISBN: 978-0-620-60270-9 Council for Medical Schemes T 012 431 0500 F 012 431 7644 E information@medicalschemes.comwww.medicalschemes.comANNUAL REPORT 2013/2014 1 Contents Annual Report of the Council of Medical Schemes 2013/14Part A: General Information General information þ 6 þ List of tables þ 13 þ List of annexures þ 17 þ þ þ Report of the Chairperson of Council þ 29 þ Part B: Performance Information
CMS Councilfor Medical Schemes ANNUAL REPORT 2013/14PROTECTING THE INTERESTS OF MEMBERS PROMOTING AN ACCOUNTABLE INDUSTRY ANNUAL REPORT COUNCIL FOR MEDICAL SCHEMESRP91/2014 ISBN: 978-0-620-60270-9 Council for Medical Schemes T 012 431 0500 F 012 431 7644 E information@medicalschemes.comwww.medicalschemes.comANNUAL REPORT 2013/2014 1 Contents Annual Report of the Council of Medical Schemes 2013/14Part A: General Information General information þ 6 þ List of tables þ 13 þ List of annexures þ 17 þ þ þ Report of the Chairperson of Council þ 29 þ Part B: Performance Information
Weighting score:0.0628081
AdminWrkshpMnl20140306.pdf
ADMINISTRATOR WORKSHOP MARCH 2014 Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
ADMINISTRATOR WORKSHOP MARCH 2014 Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com
Weighting score:0.0628081
FairTreatmentBrochure.pdf
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 T elephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com DRAFTDOCUMENTf or discussion purposesA workshop, open to all relevant stakeholders, will take place on 19and 20 February 2004 After input has been received on this report in the course of this workshop, the report will be finalized and its contents will be used as a blueprint for actions by the Council for Medical Schemes in relation to promotion of fair treatment in the short, medium and longer terms. COUNCILFORMEDICALSCHEMESF airT reatment Project OUR VISIONA medical schemes industry which is regulated to protect the interests of m embers and to promote fair
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 T elephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com DRAFTDOCUMENTf or discussion purposesA workshop, open to all relevant stakeholders, will take place on 19and 20 February 2004 After input has been received on this report in the course of this workshop, the report will be finalized and its contents will be used as a blueprint for actions by the Council for Medical Schemes in relation to promotion of fair treatment in the short, medium and longer terms. COUNCILFORMEDICALSCHEMESF airT reatment Project OUR VISIONA medical schemes industry which is regulated to protect the interests of m embers and to promote fair
Weighting score:0.0628081
Radiology 2005.pdf
Radiology 2005 13 Feb 2005 Page 2 of 44 Version 02.05 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. All other consumables are
Radiology 2005 13 Feb 2005 Page 2 of 44 Version 02.05 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. All other consumables are
Weighting score:0.0628081
Radiology 2005v2.06.pdf
Radiology 2005 13 Feb 2005 Page 2 of 44 Version 02.05 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. All other consumables are
Radiology 2005 13 Feb 2005 Page 2 of 44 Version 02.05 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. All other consumables are
Weighting score:0.0628081
Radiology 2006.pdf
Radiology 2006 01 Sep 2005 Page 2 of 45 Version 2006.02 \225 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up. \225 Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. \225 All other consumables are
Radiology 2006 01 Sep 2005 Page 2 of 45 Version 2006.02 \225 Contrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up. \225 Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net ac quisition cost, without mark up, until the implementation of Act 90. \225 All other consumables are
Weighting score:0.0628081
Radiology 2006pluscpix.pdf
Code Description Ver Add Nuclear Medicine Radiology RVU Fee RVU Fee 18 Dec 2006 Page 2 of 44 Version 2007.03 Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR gui dance) are stand alone procedures that include the regi onal study and may not be added to any of the ultrasound, CT or MR regional studies General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third
Code Description Ver Add Nuclear Medicine Radiology RVU Fee RVU Fee 18 Dec 2006 Page 2 of 44 Version 2007.03 Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR gui dance) are stand alone procedures that include the regi onal study and may not be added to any of the ultrasound, CT or MR regional studies General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third
Weighting score:0.0628081
Radiology 2006_v04.pdf
Radiology 2006 04 Nov 2005 Page 2 of 35 Version 2006.04 General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description Ver Add Radiology RVU Fee 00090 Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to
Radiology 2006 04 Nov 2005 Page 2 of 35 Version 2006.04 General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description Ver Add Radiology RVU Fee 00090 Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to
Weighting score:0.0628081
Radiology 2006_v05.pdf
Radiology 2006 20 Dec 2005 Page 2 of 36 Version 2006.05 General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description Ver Add Radiology RVU Fee 00090 Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to
Radiology 2006 20 Dec 2005 Page 2 of 36 Version 2006.05 General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description Ver Add Radiology RVU Fee 00090 Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to
Weighting score:0.0628081
Radiology 2006_v06.pdf
Radiology 2006 04 Feb 2006 Page 2 of 36 Version 2006.06 Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR gui dance) are stand alone procedures that include the regi onal study and may not be added to any of the ultrasound, CT or MR regional studies General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description
Radiology 2006 04 Feb 2006 Page 2 of 36 Version 2006.06 Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR gui dance) are stand alone procedures that include the regi onal study and may not be added to any of the ultrasound, CT or MR regional studies General Codes Modifiers 00091 Radiology and nuclear medicine services rendered to hospital inpatients 04.00 00092 Radiology and nuclear medicine serv ices rendered to outpatients 04.00 00093 A reduction of one third (33.33%) will apply to radiol ogical examinations where hos pital equipment it used 04.00 Equipment / Diagnostic Code Description
Weighting score:0.0628081
ICD-10_Coding_Standards_Ver1_06_Sep_07.pdf
The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. The South African ICD-10 Coding Standards , Version 1.06 (as at September 2007) Compiled by the National Task Team for the Implementation of ICD-10 2Table of Contents South African ICD-10 Coding Standards.......................................................................................... ................................................1 Table of Contents.............................................................................................................. ................................................................2 Acknowledgement................................................................................................................ .............................................................4 Introduction................................................................................................................... ....................................................................4 User Guide..................................................................................................................... ...................................................................5 DSN1005 Coding Chest Infection................................................................................................. ....................................................5 General Standard National (GSN)................................................................................................ ....................................................6 GSN0001 Primary Diagnosis...................................................................................................... ......................................................7 GSN0002 Secondary Diagnosis/es................................................................................................. .................................................7 GSN0003 ICD-10 Codes on Claims................................................................................................. ................................................8 GSN0004 Submission of claims................................................................................................... ....................................................8 GSN0005 ICD-10 Subsets......................................................................................................... .......................................................9 GSN0006 Level of Coding........................................................................................................ ........................................................9 Digit versus Characters........................................................................................................ .............................................................9 GSN0007 The use of Ucodes..................................................................................................... ....................................................9 GSN0008 Updating ICD-10 Codes.................................................................................................. ...............................................10 GSN0009
The SA ICD-10 Coding Standards are to be used concurre ntly with the ICD-10 volumes and training material. The South African ICD-10 Coding Standards , Version 1.06 (as at September 2007) Compiled by the National Task Team for the Implementation of ICD-10 2Table of Contents South African ICD-10 Coding Standards.......................................................................................... ................................................1 Table of Contents.............................................................................................................. ................................................................2 Acknowledgement................................................................................................................ .............................................................4 Introduction................................................................................................................... ....................................................................4 User Guide..................................................................................................................... ...................................................................5 DSN1005 Coding Chest Infection................................................................................................. ....................................................5 General Standard National (GSN)................................................................................................ ....................................................6 GSN0001 Primary Diagnosis...................................................................................................... ......................................................7 GSN0002 Secondary Diagnosis/es................................................................................................. .................................................7 GSN0003 ICD-10 Codes on Claims................................................................................................. ................................................8 GSN0004 Submission of claims................................................................................................... ....................................................8 GSN0005 ICD-10 Subsets......................................................................................................... .......................................................9 GSN0006 Level of Coding........................................................................................................ ........................................................9 Digit versus Characters........................................................................................................ .............................................................9 GSN0007 The use of Ucodes..................................................................................................... ....................................................9 GSN0008 Updating ICD-10 Codes.................................................................................................. ...............................................10 GSN0009
Weighting score:0.0628081
FairTreatmentBrochure.pdf
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 T elephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com DRAFTDOCUMENTf or discussion purposesA workshop, open to all relevant stakeholders, will take place on 19and 20 February 2004 After input has been received on this report in the course of this workshop, the report will be finalized and its contents will be used as a blueprint for actions by the Council for Medical Schemes in relation to promotion of fair treatment in the short, medium and longer terms. COUNCILFORMEDICALSCHEMESF airT reatment Project OUR VISIONA medical schemes industry which is regulated to protect the interests of m embers and to promote fair
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 T elephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com DRAFTDOCUMENTf or discussion purposesA workshop, open to all relevant stakeholders, will take place on 19and 20 February 2004 After input has been received on this report in the course of this workshop, the report will be finalized and its contents will be used as a blueprint for actions by the Council for Medical Schemes in relation to promotion of fair treatment in the short, medium and longer terms. COUNCILFORMEDICALSCHEMESF airT reatment Project OUR VISIONA medical schemes industry which is regulated to protect the interests of m embers and to promote fair
Weighting score:0.0628081
REF Solvency for Medical Schemes Final May 2005.pdf
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Solvency Implications of the REF for Medical Schemes RETAP Recommendations Report No. 5 of 2005 Adopted 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance (SHI)
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Solvency Implications of the REF for Medical Schemes RETAP Recommendations Report No. 5 of 2005 Adopted 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance (SHI)
Weighting score:0.0628081
REFSolvency-FinalMay2005.pdf.pdf
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Solvency Implications of the REF for Medical Schemes RETAP Recommendations Report No. 5 of 2005 Adopted 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance (SHI)
Recommendations by the Risk Equalisation Technical Advisory Panel to the Council for Medical Schemes Solvency Implications of the REF for Medical Schemes RETAP Recommendations Report No. 5 of 2005 Adopted 31 May 2005 Risk Equalisation Technical Advisory Panel (RETAP) Following the approval of the Social Health Insu rance (SHI)
Weighting score:0.0628081
REFsubmissions2008Completereport.pdf
\n\r ii TABLE OF CONTENTS EXECUTIVE SUMMARY.................................. ................................................... ................IV1INTRODUCTION....................................... ................................................... .....................11.1The REF shadow period 11.2Purpose of the report 12REF DATA AND METHODS: 2008 REF SUBMISSIONS......... ...........................................12.1Case definitions and benchmarks 12.1.1Entry and verification criteria.................... ................................................... ...........12.1.22008 REF weighting table........................... ................................................... ........22.1.3Estimation of expected values (CDL benchmarks)..... .............................................22.2REF data submitted for analysis 32.3Categorisation and the assessment of submitted data 32.3.1Categorisation..................................... ................................................... ................42.3.2DIN scores......................................... ................................................... .................72.3.3Evaluation of clinical credibility of submissions.. ................................................... ..72.3.4REF risk factors with deviations with significant f inancial impact...........................112.3.5Evaluation of REF submissions by administrator..... .............................................152.3.6REF price by age and community rate analyses....... ............................................163THE POTENTIAL FINANCIAL IMPACT ON SCHEMES.......... .........................................184CONCLUSIONS........................................ ................................................... ...................204.1Clinical credibility of submissions 204.2REF price by age and community rate analysis 204.3Potential financial impact on schemes 20LIST OF FIGURES
\n\r ii TABLE OF CONTENTS EXECUTIVE SUMMARY.................................. ................................................... ................IV1INTRODUCTION....................................... ................................................... .....................11.1The REF shadow period 11.2Purpose of the report 12REF DATA AND METHODS: 2008 REF SUBMISSIONS......... ...........................................12.1Case definitions and benchmarks 12.1.1Entry and verification criteria.................... ................................................... ...........12.1.22008 REF weighting table........................... ................................................... ........22.1.3Estimation of expected values (CDL benchmarks)..... .............................................22.2REF data submitted for analysis 32.3Categorisation and the assessment of submitted data 32.3.1Categorisation..................................... ................................................... ................42.3.2DIN scores......................................... ................................................... .................72.3.3Evaluation of clinical credibility of submissions.. ................................................... ..72.3.4REF risk factors with deviations with significant f inancial impact...........................112.3.5Evaluation of REF submissions by administrator..... .............................................152.3.6REF price by age and community rate analyses....... ............................................163THE POTENTIAL FINANCIAL IMPACT ON SCHEMES.......... .........................................184CONCLUSIONS........................................ ................................................... ...................204.1Clinical credibility of submissions 204.2REF price by age and community rate analysis 204.3Potential financial impact on schemes 20LIST OF FIGURES
Weighting score:0.0628081
REF_InternationalReviewPanel_Jan_2004.pdf
Report to the S S o o u u t t h h A A f f r r i i c c a a n n R R i i s s k k E E q q u u a a l l i i z z a a t t i i o o n n F F u u n n d d T T a a s s k k G G r r o o u u p p By John Armstrong John Deeble David M. Dror Nigel Rice Michael Thiede Wynand P.M.M. van de Ven The International Review Panel 16 February, 2004
Report to the S S o o u u t t h h A A f f r r i i c c a a n n R R i i s s k k E E q q u u a a l l i i z z a a t t i i o o n n F F u u n n d d T T a a s s k k G G r r o o u u p p By John Armstrong John Deeble David M. Dror Nigel Rice Michael Thiede Wynand P.M.M. van de Ven The International Review Panel 16 February, 2004
Weighting score:0.0628081
CMS_News_2nd_Edition.pdf
CMSNEWS Newsletter of the Council For Medical Schemes October 2007 October 2007LETS TALK PMBs LETS TALK PMBs CONTENTSPage Expenditure in 2006 1 Developments in Health Service Pricing2 Driving Demand for Healthcare3 Publication of the report on the analysis of
CMSNEWS Newsletter of the Council For Medical Schemes October 2007 October 2007LETS TALK PMBs LETS TALK PMBs CONTENTSPage Expenditure in 2006 1 Developments in Health Service Pricing2 Driving Demand for Healthcare3 Publication of the report on the analysis of
Weighting score:0.06217685
CMSTechSpecV1_4.pdf
Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A , Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com Annual Return Technical Guide
Chairperson: Prof. Y Veriava Chief Executive & Registrar: Dr M Gantsho Block A , Eco Glades 2 Office Park, 420 Witch - Hazel Avenue, Eco Park, Centurion, 0157 Tel: 012 431 0500 Fax: 012 430 7644 Customer Care: 0861 123 267 Information@medicalschemes.com www.medicalschemes.com Annual Return Technical Guide
Weighting score:0.06217685
Medical Technology 2005.pdf
Medical Technology 2005 13 Feb 2005 Page 1 of 20 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDI CAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service
Medical Technology 2005 13 Feb 2005 Page 1 of 20 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDI CAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service
Weighting score:0.06217685
Medical Technology 2005v2.06.pdf
Medical Technology 2005 13 Feb 2005 Page 1 of 20 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDI CAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service
Medical Technology 2005 13 Feb 2005 Page 1 of 20 Version 02.05 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDI CAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rat her intended to serve as a baseline against wh ich medical schemes can individually det ermine benefit levels and health service providers can individually determine fees c harged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a partic ular health service
Weighting score:0.06217685
Medical Technology 2006.pdf
Medical Technology 2006 11 Oct 2005 Page 1 of 16 Version 2006.03 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Medical Technology 2006 11 Oct 2005 Page 1 of 16 Version 2006.03 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Weighting score:0.06217685
Medical Technology 2006pluscpix.pdf
Medical Technology 2007 18 Dec 2006 Page 1 of 16 Version 2007.03 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Medical Technology 2007 18 Dec 2006 Page 1 of 16 Version 2007.03 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2007 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Weighting score:0.06217685
Medical Technology 2006_v04.pdf
Medical Technology 2006 04 Nov 2005 Page 1 of 16 Version 2006.04 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Medical Technology 2006 04 Nov 2005 Page 1 of 16 Version 2006.04 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2006 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Weighting score:0.06217685
Medical Technology 2006_v06.pdf
Medical Technology 2006 04 Feb 2006 Page 1 of 16 Version 2006.06 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Medical Technology 2006 04 Feb 2006 Page 1 of 16 Version 2006.06 NATIONAL REFERENCE PRICE LIST FOR SERVICES BY MEDICAL LABORATORY TECHNOLOGISTS, WITH EFFECT FROM 1 JANUARY 2005 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rath er intended to serve as a baseline against which medical schemes c an individually determine benefit levels and health service provi ders can individuall y determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular h ealth service
Weighting score:0.06217685
CMSNews201404.pdf
COSTING OF PMB sCMS News Plus STRUCTURAL ISSUES CONSEQUENCES UNINTENDED the prescribed minimum benefits issue FOR HEALTHCARE FUNDINGCONTENTS04 The PMB Conundrum 07 PMBs and the private healthcare consumer 12 Costing of PMBs 23 Levelling the playing field 26 What is PMB level of care? 29 Know your rights as a consumer CMS News www.medicalschemes.comEditorial Committee Dr Elsabe Conradie Dr Anton de Villiers Nondumiso Khumalo Editor Silindubuhle Mnqeta CMS Address Block A Eco Glades 2 Office Park 420 Witch-Hazel Avenue Eco Park Centurion 0157CopyrightCMS News is published by
COSTING OF PMB sCMS News Plus STRUCTURAL ISSUES CONSEQUENCES UNINTENDED the prescribed minimum benefits issue FOR HEALTHCARE FUNDINGCONTENTS04 The PMB Conundrum 07 PMBs and the private healthcare consumer 12 Costing of PMBs 23 Levelling the playing field 26 What is PMB level of care? 29 Know your rights as a consumer CMS News www.medicalschemes.comEditorial Committee Dr Elsabe Conradie Dr Anton de Villiers Nondumiso Khumalo Editor Silindubuhle Mnqeta CMS Address Block A Eco Glades 2 Office Park 420 Witch-Hazel Avenue Eco Park Centurion 0157CopyrightCMS News is published by
Weighting score:0.05329444
DiscussionDocOnPriceDetermination.pdf
DISCUSSION DOCUMENT THE DETERMINATION OF HEALTH PRICES IN THE PRIVATE SECTOR Version 1 .00 28 October 2010 2 Version 1 .00: Discussion document on the determination of health prices in the private sector Table of Contents 1 Background and purpose of this document ................................ ................................ ........................... 3 2 Consultative process to
DISCUSSION DOCUMENT THE DETERMINATION OF HEALTH PRICES IN THE PRIVATE SECTOR Version 1 .00 28 October 2010 2 Version 1 .00: Discussion document on the determination of health prices in the private sector Table of Contents 1 Background and purpose of this document ................................ ................................ ........................... 3 2 Consultative process to
Weighting score:0.05329444
(3) SAMA NHRPL Final Report _May 2006.pdf
TABLE OF CONTENTS INTRODUCTION 1 DATA RECEIVED 2 VARIABLES 3 METHODOLOGY 4 ISSUES ENCOUNTERED 5 SUGGESTED APPROACHES 7 PROCESS 10 SPECIFIC SUBMISSIONS 11 ANALYSES PER GROUP 15 PROJECTED IMPACT ON NATIONAL HEALTH REFERENCE PRICE LIST FOR 2007 29 RELATIVE VALUE UNITS 29 CONCLUSION 30 2 With the exception of specialised equipment data/information has been received pertaining to all of the above parameters and submissions have been prepared accordingly. Due to the variety and the complexity of the issues pertaining to the specialised equipment, it was our brief to exclude all specialised equipment from the submissions for 2007. These will and should be dealt with during a next round of submissions. However, the acquisition cost of the specialised equipment has been taken into account in the calculation of the provisions for bad debt as per the prescribed formulae. Data received Data was received from various sources and pertaining to a variety of disciplines: Discipline Data source 1. Anaesthesiologists South African Society for Anaesthesiologists (SASA) survey 2. Cardio Thoracic surgeons South African Society for Cardio Thoracic Surgeons (SASCTS) survey 3. Cardiologists HealthMan 4. General practitioners SAMA survey 5. Gynaecologists HealthMan 6. Neurosurgeons HealthMan 7. Ophthalmologists HealthMan 8. Orthopaedics HealthMan 9. Otorhinolaryngologists HealthMan 10. Paediatricians HealthMan 11. Physicians HealthMan 12. Plastic and Reconstructive Surgeons SAMA survey 13. Psychiatrists HealthMan 14. Pulmonologists HealthMan 15. Rheumatologists HealthMan 16.
TABLE OF CONTENTS INTRODUCTION 1 DATA RECEIVED 2 VARIABLES 3 METHODOLOGY 4 ISSUES ENCOUNTERED 5 SUGGESTED APPROACHES 7 PROCESS 10 SPECIFIC SUBMISSIONS 11 ANALYSES PER GROUP 15 PROJECTED IMPACT ON NATIONAL HEALTH REFERENCE PRICE LIST FOR 2007 29 RELATIVE VALUE UNITS 29 CONCLUSION 30 2 With the exception of specialised equipment data/information has been received pertaining to all of the above parameters and submissions have been prepared accordingly. Due to the variety and the complexity of the issues pertaining to the specialised equipment, it was our brief to exclude all specialised equipment from the submissions for 2007. These will and should be dealt with during a next round of submissions. However, the acquisition cost of the specialised equipment has been taken into account in the calculation of the provisions for bad debt as per the prescribed formulae. Data received Data was received from various sources and pertaining to a variety of disciplines: Discipline Data source 1. Anaesthesiologists South African Society for Anaesthesiologists (SASA) survey 2. Cardio Thoracic surgeons South African Society for Cardio Thoracic Surgeons (SASCTS) survey 3. Cardiologists HealthMan 4. General practitioners SAMA survey 5. Gynaecologists HealthMan 6. Neurosurgeons HealthMan 7. Ophthalmologists HealthMan 8. Orthopaedics HealthMan 9. Otorhinolaryngologists HealthMan 10. Paediatricians HealthMan 11. Physicians HealthMan 12. Plastic and Reconstructive Surgeons SAMA survey 13. Psychiatrists HealthMan 14. Pulmonologists HealthMan 15. Rheumatologists HealthMan 16.
Weighting score:0.05329444
2004-2005 CMS Annual Report_2005.pdf
COUNCILFORMEDICALSCHEMES1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 Te lephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.com Council for Medical SchemesANNUAL REPORT 2004-5 1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 T elephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.comNumber:RP146/2005 ISBN:0-061-36049-X COUNCILFORMEDICALSCHEMES Strategic ObjectivesSecure an appropriate level of protection for beneficiaries of medical schemes and the public by authorising the conduct of medical schemes business and monitoring the financial performance and soundness of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees, beneficiaries and the public. F oster compliance with the Act by medical schemes,administrators,managed care entities and brokers and initiate enforcement action where required. Investigate and resolve complaints
COUNCILFORMEDICALSCHEMES1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 Te lephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.com Council for Medical SchemesANNUAL REPORT 2004-5 1267 Pretorius Street,Hadefields Block E,Hatfield,Pretoria Private Bag X34,Hatfield 0028 T elephone:012 431 0500 Telefax:012 430 7644 www.medicalschemes.comNumber:RP146/2005 ISBN:0-061-36049-X COUNCILFORMEDICALSCHEMES Strategic ObjectivesSecure an appropriate level of protection for beneficiaries of medical schemes and the public by authorising the conduct of medical schemes business and monitoring the financial performance and soundness of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees, beneficiaries and the public. F oster compliance with the Act by medical schemes,administrators,managed care entities and brokers and initiate enforcement action where required. Investigate and resolve complaints
Weighting score:0.04441204
CMS ANNUAL REPORT 2001.pdf
Annual report of the Registrar of Medical Schemes2001 COUNCILFORMEDICALSCHEMES Our visionA medical schemes industry which is regulated to protect the interests of members and to promote fair and equitable access to private health financing in order to maximise the health of South Africa.Our MissionThe Council will act in an administratively fair and transparent manner with integrity and professionalism and will achieve this vision by: \245Informing the public about their rights and obligations in respect of access to medical schemes; \245Ensuring that all entities co nducting the business of medical schemes comply with the Act; \245Ensuring that complaints raised by members and the public are handled appropriately and speedily; \245Contributing to improved management and governance of medical schemes;
Annual report of the Registrar of Medical Schemes2001 COUNCILFORMEDICALSCHEMES Our visionA medical schemes industry which is regulated to protect the interests of members and to promote fair and equitable access to private health financing in order to maximise the health of South Africa.Our MissionThe Council will act in an administratively fair and transparent manner with integrity and professionalism and will achieve this vision by: \245Informing the public about their rights and obligations in respect of access to medical schemes; \245Ensuring that all entities co nducting the business of medical schemes comply with the Act; \245Ensuring that complaints raised by members and the public are handled appropriately and speedily; \245Contributing to improved management and governance of medical schemes;
Weighting score:0.04441204
CMS-AR-2011-WEB.pdf
Annual Report2010~2011 RP | 52/2011 ISBN | 978 0 621 40011 3 Council for Medical Schemes Private Bag X34 Hatfield 0028 Pretoria t | + 27 (0)12 431 0500 f | + 27 (0)12 430 7644 e | information@medicalschemes.com w | www.medicalschemes.com Annual Report2010~2011 The Council for Medical Schemes serves South Africa by learning from international experience - welcome to our world! ContentsPart 1: the Council for Medical Schemes 1 April 2010-31 March 2011Corporate overview 8 Profile 10 Vision 10 Mission 11 Approach 11 Our key strategic
Annual Report2010~2011 RP | 52/2011 ISBN | 978 0 621 40011 3 Council for Medical Schemes Private Bag X34 Hatfield 0028 Pretoria t | + 27 (0)12 431 0500 f | + 27 (0)12 430 7644 e | information@medicalschemes.com w | www.medicalschemes.com Annual Report2010~2011 The Council for Medical Schemes serves South Africa by learning from international experience - welcome to our world! ContentsPart 1: the Council for Medical Schemes 1 April 2010-31 March 2011Corporate overview 8 Profile 10 Vision 10 Mission 11 Approach 11 Our key strategic
Weighting score:0.04441204
AdministratorWorkshopManual.pdf
ADMINISTRATOR WORKSHOP MARCH 2012 AGENDA ADMINISTRATOR WORKSHOP MARCH 2012
ADMINISTRATOR WORKSHOP MARCH 2012 AGENDA ADMINISTRATOR WORKSHOP MARCH 2012
Weighting score:0.04441204
CMSNews2.pdf
Newsletter of the Council for Medical Schemes No.1 2003 Turnaround in financial position of schemes Fair treatment under the spotlightWork continues on prescribed minimum benefits and chronic cover In this issue 2 3 4 5 7 Financial soundness of medical schemes Cost of benefit changes 9 10 12 Employers bid to pr otect staf f fr om HIV/AIDS Savings accounts & solvency - to include or not to include Belgians in Hatfield Council gets to bottom of complaints Regulating risk 6 Fair tr eatment under the spotlight A work in pr ogr ess: Chr onic disease and pr escribed minimum benefits T he Medical Schemes Act places gr eat r eliance on the appr opri - ate gover nance of medical schemes by independent tr ustees of schemes. The Act r equir es that at least fifty per cent of boar d tr ustees should be elected by
Newsletter of the Council for Medical Schemes No.1 2003 Turnaround in financial position of schemes Fair treatment under the spotlightWork continues on prescribed minimum benefits and chronic cover In this issue 2 3 4 5 7 Financial soundness of medical schemes Cost of benefit changes 9 10 12 Employers bid to pr otect staf f fr om HIV/AIDS Savings accounts & solvency - to include or not to include Belgians in Hatfield Council gets to bottom of complaints Regulating risk 6 Fair tr eatment under the spotlight A work in pr ogr ess: Chr onic disease and pr escribed minimum benefits T he Medical Schemes Act places gr eat r eliance on the appr opri - ate gover nance of medical schemes by independent tr ustees of schemes. The Act r equir es that at least fifty per cent of boar d tr ustees should be elected by
Weighting score:0.04441204
CMS Strategic Plans 2013_14.pdf
STRATEGIC PLAN 2013/14 F OR THE FISCAL YEARS 2011/12 2014/15 Final 8 November 2012 Table of Contents Foreword ................................ ................................ ................................ ................................ .............. vi Certification ................................ ................................ ................................ ................................ ......... vii Part A: Strategi c overview ................................ ................................ ................................ ................... 8
STRATEGIC PLAN 2013/14 F OR THE FISCAL YEARS 2011/12 2014/15 Final 8 November 2012 Table of Contents Foreword ................................ ................................ ................................ ................................ .............. vi Certification ................................ ................................ ................................ ................................ ......... vii Part A: Strategi c overview ................................ ................................ ................................ ................... 8
Weighting score:0.04441204
CMS PMB Four Character Coding July 2005.pdf
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
Weighting score:0.04441204
CMSCommentsOnDraftNHIPolicy_20120119.pdf
C OMMENTS ON THE N ATIONAL H EALTH I NSURANCE P OLICY P APER OF 12 A UGUST 2011 C OUNCIL FOR M EDICAL S CHEMES 19 J ANUARY 201 2 Page | iii CMS COMMENTS ON P ROPOSED P OLICY ON N ATIONAL H EALTH
C OMMENTS ON THE N ATIONAL H EALTH I NSURANCE P OLICY P APER OF 12 A UGUST 2011 C OUNCIL FOR M EDICAL S CHEMES 19 J ANUARY 201 2 Page | iii CMS COMMENTS ON P ROPOSED P OLICY ON N ATIONAL H EALTH
Weighting score:0.04441204
Dental Practitioners 2005.pdf
Dental Practitioners 2005 14 Feb 2005 Page 2 of 35 Version 02.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (P LUS L) shall be indicated on the dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the relevant dental procedure code on the date on which the dental procedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental lab oratory service codes shall be reported on the
Dental Practitioners 2005 14 Feb 2005 Page 2 of 35 Version 02.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (P LUS L) shall be indicated on the dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the relevant dental procedure code on the date on which the dental procedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental lab oratory service codes shall be reported on the
Weighting score:0.04441204
Dental Practitioners 2005v2.06.pdf
Dental Practitioners 2005 14 Feb 2005 Page 2 of 35 Version 02.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (P LUS L) shall be indicated on the dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the relevant dental procedure code on the date on which the dental procedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental lab oratory service codes shall be reported on the
Dental Practitioners 2005 14 Feb 2005 Page 2 of 35 Version 02.05 Electronic submission of invoices. Fees charged by dental technicians for laboratory services (P LUS L) shall be indicated on the dentist's invoice by submitting code 8099 - Dental laboratory service with the appropriate laboratory fee on the line following the relevant dental procedure code on the date on which the dental procedure was rendered. The laboratory fee shall be submitted for payment on the date on which the procedure code is submitted for payment, and the appropriate dental lab oratory service codes shall be reported on the
Weighting score:0.04441204
Radiology 2004.pdf
Radiology 2004 09 Sep 2004 Page 2 of 52 Version 01.11 Contrast Medium o Prior to the implementation of Act 90, contrast will be bill ed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be b illed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and ot her embolisation materials, guide wires and drains are to be billed at net acquisition cost, without mark up, until the implementation of Act 90. All other consumables are
Radiology 2004 09 Sep 2004 Page 2 of 52 Version 01.11 Contrast Medium o Prior to the implementation of Act 90, contrast will be bill ed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be b illed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and ot her embolisation materials, guide wires and drains are to be billed at net acquisition cost, without mark up, until the implementation of Act 90. All other consumables are
Weighting score:0.04441204
NEJM article2.pdf
n engl j med 351;26 www.nejm.orgdecember 23, 2004 The new england journal of medicine 2715 review article drug therapy Immunosuppressive Drugs for Kidney Transplantation Philip F. Halloran, M.D., Ph.D. From the Division of Nephrology and Trans- plantation Immunology, University of Alber- ta, Ed monton, Canada. Address reprint re- quests to Dr. Halloran at 250 Heritage Medical Research Centre, Edmonton, AB T6G 2S2, Canada, or at phil.halloran@ ualberta.ca. N Engl J Med 2004;351:2715-29. Copyright © 2004 Massachusetts Medical Society. he central issue in organ transplantation remains suppres- sion of allograft rejection. Thus, development of immunosuppressive drug\s is the key to successful allograft function.
n engl j med 351;26 www.nejm.orgdecember 23, 2004 The new england journal of medicine 2715 review article drug therapy Immunosuppressive Drugs for Kidney Transplantation Philip F. Halloran, M.D., Ph.D. From the Division of Nephrology and Trans- plantation Immunology, University of Alber- ta, Ed monton, Canada. Address reprint re- quests to Dr. Halloran at 250 Heritage Medical Research Centre, Edmonton, AB T6G 2S2, Canada, or at phil.halloran@ ualberta.ca. N Engl J Med 2004;351:2715-29. Copyright © 2004 Massachusetts Medical Society. he central issue in organ transplantation remains suppres- sion of allograft rejection. Thus, development of immunosuppressive drug\s is the key to successful allograft function.
Weighting score:0.04441204
CMS PMB Four Character Coding July 2005.pdf
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
Weighting score:0.04441204
BDProstateCancer.pdf
Draft Benefit Definition - Prostate Cancer 23 March 2012 Table of Contents 1. Introduction ................................ ................................ ................................ ................................ 4 2. Epidemiology ................................ ................................ ................................ ............................... 4 3. Scope ................................ ................................ ................................ ................................ ........... 4 4. PMB and ICD10 Codes ................................ ................................ ................................ ................. 4 5.
Draft Benefit Definition - Prostate Cancer 23 March 2012 Table of Contents 1. Introduction ................................ ................................ ................................ ................................ 4 2. Epidemiology ................................ ................................ ................................ ............................... 4 3. Scope ................................ ................................ ................................ ................................ ........... 4 4. PMB and ICD10 Codes ................................ ................................ ................................ ................. 4 5.
Weighting score:0.04441204
CMS PMB Four Character Coding July 2005.pdf
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
CMS July 2005PMB Coding 4th Character Final Dcoument July 2005Page 1 of 69 CodeDiagnosisTreatment A80.0Acute paralytic poliomyelitis, vaccine-associated A80.1Acute paralytic poliomyelitis, wild virus, imported A80.2Acute paralytic poliomyelitis, wild virus, indigenous A80.3Acute paralytic poliomyelitis, other and unspecified A80.9Acute poliomyelitis, unspecified G61.0Guillain-Barré syndrome G20Parkinson's disease G23.8Other specified degenerative diseases of basal ganglia G23.9Degenerative disease of basal ganglia, unspecified G24.0Drug-induced dystonia G24.1Idiopathic familial dystonia G24.2Idiopathic nonfamilial dystonia G24.3Dystonia - Spasmodic torticollis G24.4Idiopathic orofacial dystonia G24.8Other dystonia G24.9Dystonia unspecified G25.8Other extrapyramidal and movement disorders - Other specified extrapyramidal and movement disorders G25.9Extrapyramidal and movement disorder unspecified C70.0Malignant neoplasm, cerebral meninges C70.1Malignant neoplasm, spinal meninges C70.9Malignant neoplasm, meninges, unspecified C71.0Malignant neoplasm, cerebrum except lobes and ventricles C71.1Malignant neoplasm, frontal lobe C71.2Malignant neoplasm, temporal lobe C71.3Malignant neoplasm, parietal lobe C71.4Malignant neoplasm,
Weighting score:0.04441204
CMS_Five_Year_Review_Document.pdf
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 Telephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com Regulating in the public interest:Taking stock and looking to the futureA Five-Year Review of the Council for Medical Schemes COUNCILFORMEDICALSCHEMES OUR VISIONA medical schemes industry which is regulated to protect the interests of members and to promote fair and equitable access to private health financing in order to maximise the health of South Africa.STRATEGIC OBJECTIVES¥Secure an appropriate level of protection of beneficiaries of medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial performance and soundness of schemes; ¥Provide support and
COUNCILFORMEDICALSCHEMES1267 Pretorius Street, Hadefields Block E, Hatfield, Pretoria Private Bag X34, Hatfield 0028 Telephone: 012 431 0500 Telefax:012 430 7644 www.medicalschemes.com Regulating in the public interest:Taking stock and looking to the futureA Five-Year Review of the Council for Medical Schemes COUNCILFORMEDICALSCHEMES OUR VISIONA medical schemes industry which is regulated to protect the interests of members and to promote fair and equitable access to private health financing in order to maximise the health of South Africa.STRATEGIC OBJECTIVES¥Secure an appropriate level of protection of beneficiaries of medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial performance and soundness of schemes; ¥Provide support and
Weighting score:0.04441204
Report_on_MedicalScheme_Cost_Increases.pdf
2COUNCIL FOR MEDICAL SCHEMES Research briefNo 1 of 2008 CONTENTSFOREWORD 7 EXECUTIVE SUMMARY 9 1.INTRODUCTION 15 2.HISTORICAL CONTEXT 17 3.BREAKDOWN OF MEDICAL SCHEME COSTS 21 4.HOSPITAL COSTS 23 5.OUT-OF-HOSPITAL COSTS 35 6.NON-HEALTH COSTS 41 7.DISCUSSION AND FINDINGS 45 REFERENCES 49 ANNEXURE A: HAVE CHANGES IN THE AGE STRUCTURE OF MEDICAL SCHEME MEMBERS CAUSED THE COST INCREASES?51 ANNEXURE B: THE REMUNERATION OF MEDICAL PRACTITIONERS FROM 1968 TO 198655 ANNEXURE C: COMMUNICATIONS SENT TO SPECIALIST GROUPS BY THEIR ASSOCIATIONS57 A CKNOWLEDGEMENTS 59 Evaluation of Medical Schemes' Cost Increases: Findings and Recommendations 3 T ABLEST able 4.1:Hospital expenditure in 2000, 2006 and projected to 2010 (R' million) (2006 prices) (based on 6,981,724 beneficiaries) 24 T able 4.2:Bed need versus supply for the private health sector (2004) 31 T able 5.1:Specialist costs including scheme co-payments
2COUNCIL FOR MEDICAL SCHEMES Research briefNo 1 of 2008 CONTENTSFOREWORD 7 EXECUTIVE SUMMARY 9 1.INTRODUCTION 15 2.HISTORICAL CONTEXT 17 3.BREAKDOWN OF MEDICAL SCHEME COSTS 21 4.HOSPITAL COSTS 23 5.OUT-OF-HOSPITAL COSTS 35 6.NON-HEALTH COSTS 41 7.DISCUSSION AND FINDINGS 45 REFERENCES 49 ANNEXURE A: HAVE CHANGES IN THE AGE STRUCTURE OF MEDICAL SCHEME MEMBERS CAUSED THE COST INCREASES?51 ANNEXURE B: THE REMUNERATION OF MEDICAL PRACTITIONERS FROM 1968 TO 198655 ANNEXURE C: COMMUNICATIONS SENT TO SPECIALIST GROUPS BY THEIR ASSOCIATIONS57 A CKNOWLEDGEMENTS 59 Evaluation of Medical Schemes' Cost Increases: Findings and Recommendations 3 T ABLEST able 4.1:Hospital expenditure in 2000, 2006 and projected to 2010 (R' million) (2006 prices) (based on 6,981,724 beneficiaries) 24 T able 4.2:Bed need versus supply for the private health sector (2004) 31 T able 5.1:Specialist costs including scheme co-payments
Weighting score:0.04441204
ReportMedicalSchemeCostIncreases.pdf
PRESS RELEASE 3 of 2008 COUNCIL FOR MEDICAL SC HEMES RELEASES REPORT ON MEDICAL SCHEMES COST INCREASES Private health cost increases are unsus tainable and unjustifiable in significant respects. Without corrective governm ent interventions, continuing cost escalation will have long-term impacts on access to health care through medical schemes. This is according to a report released on Thursday 3 April by the Council for Medical Schemes, which details its evaluat ion of the causes of medical scheme cost escalation and its recommendations on what needs to be done to contain the increases.
PRESS RELEASE 3 of 2008 COUNCIL FOR MEDICAL SC HEMES RELEASES REPORT ON MEDICAL SCHEMES COST INCREASES Private health cost increases are unsus tainable and unjustifiable in significant respects. Without corrective governm ent interventions, continuing cost escalation will have long-term impacts on access to health care through medical schemes. This is according to a report released on Thursday 3 April by the Council for Medical Schemes, which details its evaluat ion of the causes of medical scheme cost escalation and its recommendations on what needs to be done to contain the increases.
Weighting score:0.04441204
CMS Strategic Plans 2013_14.pdf
STRATEGIC PLAN 2013/14 F OR THE FISCAL YEARS 2011/12 2014/15 Final 8 November 2012 Table of Contents Foreword ................................ ................................ ................................ ................................ .............. vi Certification ................................ ................................ ................................ ................................ ......... vii Part A: Strategi c overview ................................ ................................ ................................ ................... 8
STRATEGIC PLAN 2013/14 F OR THE FISCAL YEARS 2011/12 2014/15 Final 8 November 2012 Table of Contents Foreword ................................ ................................ ................................ ................................ .............. vi Certification ................................ ................................ ................................ ................................ ......... vii Part A: Strategi c overview ................................ ................................ ................................ ................... 8
Weighting score:0.04441204
Consolidated_Regulatory_Plan_and_Budget 200910.pdf
COU N CILFO R EDICA L SCHEMESMCOU N CILFO R EDICA L SCHEMESM COU N CILFO R MEDICA L SCHEMESRegulatoryPlanandBudget 2009/10 STRATEGIC OBJECTIVES Secure an appropriate level of protection of beneficiaries o medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees, beneficiaries and the public. Foster compliance with the Act by medical schemes, administrators and brokers and initiate enforcement action where required. Investigate and resolve
COU N CILFO R EDICA L SCHEMESMCOU N CILFO R EDICA L SCHEMESM COU N CILFO R MEDICA L SCHEMESRegulatoryPlanandBudget 2009/10 STRATEGIC OBJECTIVES Secure an appropriate level of protection of beneficiaries o medical schemes and the public by authorizing the conduct of medical schemes business and monitoring the financial performance of schemes. Provide support and guidance to trustees and promote understanding of the medical schemes environment by trustees, beneficiaries and the public. Foster compliance with the Act by medical schemes, administrators and brokers and initiate enforcement action where required. Investigate and resolve
Weighting score:0.04441204
Report_on_Cost_Inc.pdf
2COUNCIL FOR MEDICAL SCHEMES Research briefNo 1 of 2008 CONTENTSFOREWORD 7 EXECUTIVE SUMMARY 9 1.INTRODUCTION 15 2.HISTORICAL CONTEXT 17 3.BREAKDOWN OF MEDICAL SCHEME COSTS 21 4.HOSPITAL COSTS 23 5.OUT-OF-HOSPITAL COSTS 35 6.NON-HEALTH COSTS 41 7.DISCUSSION AND FINDINGS 45 REFERENCES 49 ANNEXURE A: HAVE CHANGES IN THE AGE STRUCTURE OF MEDICAL SCHEME MEMBERS CAUSED THE COST INCREASES?51 ANNEXURE B: THE REMUNERATION OF MEDICAL PRACTITIONERS FROM 1968 TO 198655 ANNEXURE C: COMMUNICATIONS SENT TO SPECIALIST GROUPS BY THEIR ASSOCIATIONS57 A CKNOWLEDGEMENTS 59 Evaluation of Medical Schemes' Cost Increases: Findings and Recommendations 3 T ABLEST able 4.1:Hospital expenditure in 2000, 2006 and projected to 2010 (R' million) (2006 prices) (based on 6,981,724 beneficiaries) 24 T able 4.2:Bed need versus supply for the private health sector (2004) 31 T able 5.1:Specialist costs including scheme co-payments
2COUNCIL FOR MEDICAL SCHEMES Research briefNo 1 of 2008 CONTENTSFOREWORD 7 EXECUTIVE SUMMARY 9 1.INTRODUCTION 15 2.HISTORICAL CONTEXT 17 3.BREAKDOWN OF MEDICAL SCHEME COSTS 21 4.HOSPITAL COSTS 23 5.OUT-OF-HOSPITAL COSTS 35 6.NON-HEALTH COSTS 41 7.DISCUSSION AND FINDINGS 45 REFERENCES 49 ANNEXURE A: HAVE CHANGES IN THE AGE STRUCTURE OF MEDICAL SCHEME MEMBERS CAUSED THE COST INCREASES?51 ANNEXURE B: THE REMUNERATION OF MEDICAL PRACTITIONERS FROM 1968 TO 198655 ANNEXURE C: COMMUNICATIONS SENT TO SPECIALIST GROUPS BY THEIR ASSOCIATIONS57 A CKNOWLEDGEMENTS 59 Evaluation of Medical Schemes' Cost Increases: Findings and Recommendations 3 T ABLEST able 4.1:Hospital expenditure in 2000, 2006 and projected to 2010 (R' million) (2006 prices) (based on 6,981,724 beneficiaries) 24 T able 4.2:Bed need versus supply for the private health sector (2004) 31 T able 5.1:Specialist costs including scheme co-payments
Weighting score:0.04441204
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