Medical schemes back new tariffs

2012-08-15 18:07

Johannesburg - New health tariffs will help to stabilise medical costs and provide certainty to medical schemes and patients, the Board of Healthcare Providers said on Wednesday.

"We feel that this is a much-needed first step in bringing about certainty to medical schemes and their members," BHF managing director Humphrey Zokufa said in a statement.

"Nowhere else in the world is there a situation where healthcare providers do not have a pricing guideline to work off."

Zokufa said medical scheme providers had been prohibited from discussing tariffs with healthcare providers due to a Competition Commission ruling in 2005.

He said a reference price list had been ended by a High Court order in 2010 and no guidelines had existed to replace them until the new tariffs were proposed.

"There has been no tariff or pricing guideline on healthcare provider charges, therefore allowing for opportunistic charging by some healthcare providers, and putting severe strain on the pockets of patients," Zokufa said.

The Health Professions Council of SA (HPCSA) announced the new guidelines on Tuesday. The council hoped the new regulations would promote transparency and end billing surprises.

The tariff guidelines were a yardstick and practitioners could charge more than stipulated, provided there was consent from the patient or a relative.

The BHF said it supported patients having to be consulted by the healthcare provider if the fee exceeded HPCSA tariffs.

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  • - 2012-08-15 18:20

    Anything with the word 'scheme' gives me chills like Pyramid Scheme etc.

  • Christi Vaughn Roestorff - 2012-08-15 18:47

    "could charge more, provided there was consent"... "sorry Sir/Mam but without this procedure you will die, now sign here!" Do these "people" not see the problem? This happens in nature we call said animals predators and scavengers...

      Adil Smit - 2012-08-15 19:53

      According to government medical aids have to cover your costs in life and death situations - PMB's

  • opinion.blake - 2012-08-15 18:52

    Again to the courts. Goodness! Who gives these morons legal advice? Can't the HPCSA learn from department of health's mistakes? The only winners of the HPCSA's bully tactics will be the bank accounts of the advocates. Good for you, without you guys the banana republic would be in full swing!

  • winifred.watson.9 - 2012-08-15 19:22

    Well this is certainly a start and at least now we will be informed before just how much we are going to be out of pocket instead of getting a shock. Somebody took me to task for complaining but we do need some sort of guidline and doctor and specialists should inform us of the costs upfront which they dont do now unless you bully them. Medical aids are also at fault, they dont educate the members either about what to expect or what to do. Medical aid is expensive and so is decent medical care but please between the two poor joe soap is caught in the middle. This needs to be thrashed out and urgently. Most of these specialists have shares in the relative private hospitals these days.

      wendy.webb.980 - 2012-08-16 10:12

      Medical aids do educate their members. They are provided with all the information up-front. This includes what they cover, what is excluded, how to arrange hospital admissions, which doctors and dentists you can go to if there is a network, etc. Problem is most people don't bother to read. This information is updated annually, and advised to the members. It's amazing how many people have access to the internet to complain, but not to inform themselves because all this information is on the medical aids' websites.

  • quartus.vanzyl - 2012-08-15 20:53

    If only we can stop this practice were health providers insist on payment upfront. What is the use then of having a medical aid scheme?

      Pieter Aucamp - 2012-08-15 21:57

      Like you explain a Drain Surgeon Call out fee is >R500. But you medical aid pays R230 incl the VAT and then when the bill is submitted you can make the sum. Life changing diagnosis and info for R165. The price of a decent Rump stake. After 13 years at med school?

      wendy.webb.980 - 2012-08-16 10:16

      Some health providers do this because their rates are above what the medical aid covers, and in such cases any payments have to go to the medical aid member rather than the provider. The members then frequently spend their refund and the provider doesn't even get that as part payment of the account.

  • ruben.maistry - 2012-08-15 21:09


      opinion.blake - 2012-08-15 22:20

      So why then don't we just send all the doctors to jail? You've got the evidence don't you!

      thasmeel.singh - 2012-08-16 10:37

      1 thing that must be investigated is that moments before you due to undergo surgery and are already groggy from medicines, the anaesthetist will come and tell you that he or she is contracted out of medical aid and will charge much more than the medical aid rate. then when you try to speak, he'll tell you that he hopes you have gap cover. these people charge what they want. medical rate was 9000. this man charges 20000! how do u allow something like dat? these guidelines will put them in their place!

  • maretha.mineur - 2012-08-16 05:40

    There is a very easy way to prevent being " overcharged" by these " thieves". Simply don't make use of their services! No reason to put your life in the hands of criminals...And indeed, Drain Surgeon may now charge higher fees than a medical surgeon!

  • oupa.ermos - 2012-08-16 08:44

    Trick is: Every government body in the upper echelon serves the interests of the elite. Only them can decide how to run a each portion of what they deem necessary according to their own selfish ambitions. Yes this may seem as an "adjustment" by the HPCSA, but in actual fact medical charges will continue to rise, and the poor and middle-class folks will have a lot of conditions that cannot be covered by the schemes. Its a fact! Everything else in this country is expensive and medical charges continue to rise with or without intervention by the health council. By the way S.A is ranked top with regard to the cost of medical access.

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