This practice is contracted in with most (but not all) medical aids. What this means for you as the patient is that services rendered by the practice are reimbursed by these medical aids at a predetermined rate without the need for additional copayments from the patient.

This does not include services rendered by other members of the team such as anaesthesiology, radiology and other allied head disciplines. Such rates will need to discussed directly with the service provide.

Liability
Your account remains your personal responsibility. It is your responsibility to ensure Medical aid receives the account. We will submit your account as a courtesy on your behalf, but for you to please ensure your medical aid receives the claim. You remain liable in the event of any shortfalls in payments from your medical scheme.

Should your medical aid not be able to clarify at which rates you are insured at, submit your complaints to the Council for Medical Schemes at complaints@medicalschemes.com or contact them on, telephone 012 431 0500.

Each medical aid has their own ‘scheme rate’ based on the previously used NHRPL or National Health Reference Price List. In July 2010, Acting Jude Ebersohn of the North Gauteng High Court judged the RPL to be ‘unreasonably low’ with health care practitioners not able to cover their costs at this rate and therefore declared invalid. Sadly these rates have not been revised since.

This helps one to understand why in many cases there may be a discrepancy between what your medical aid is willing to pay, and what your health care practitioner charges. Some medical aids will reimburse at the “medical aid rate” or “scheme rate” of 100% or as a percentage of this rate: for example 217% ( eg Discovery Classic) and 300% (eg Discovery Executive).

It remains your responsibility as a the patient to be knowledgeable about your medical aid option and their reimbursement rate.

In our practice we aim to have compete transparency on our billing policy as outlined below.

We do accept most medical aids for in room consultations. Please ensure that you have sufficient funds in your medical savings account (MSA) if you would like us to submit your account to medical aid.

For cash consultations, the rates are set at R850 for first consultations and R550 for follow up consultations.

Emergency or after hours consultations will be liable to an additional fee.

If you have made an appointment with Dr MA Manjra and cannot make the appointment please may you contact our rooms to cancel or reschedule, within 24 hours failure to do so will result in you being billed for the consultation.

An example of these costs include:
R500,00: Injection/infiltration of large joint (eg knee)

The medical practitioner and the practice reserve the right to charge for any additional paperwork requested by your medical aid e.g. pre-authorisations, motivation letters, chronic medication forms or reports.

As a courtesy to our patients we generally obtain authorization for surgical procedures on the patients behalf, unless otherwise instructed by the patient or main member.

A detailed estimate of the costs involved as well as an estimate of what your medical aid will likely cover will be provided to you before the procedure. The quotation is an estimate and is subject to change at the time of the actual procedure. The difference between practice cost and estimated medical aid reimbursement (if any) will be communicated to you prior to surgery. As we are contracted to most medical aids this is usually not a concern for most patients

We have a policy of not turning patients away due to cost, and will make every effort to accommodate all patients in need of treatment.

The medical practitioner and the practice reserve the right to charge for any additional paperwork requested by your medical aid e.g. pre-authorisations, motivation letters, chronic medication forms or reports. Even if the practice submits the account to a medical aid for re-imbursement, the patient ultimately remains liable for the full costs, the interest as specified in the National Credit Act, and for any costs incurred in the recovery process in the event of the account not being settled in full by the medical aid.

Should your medical aid not be able to clarify at which rates you are insured at, submit your complaints to the Council for Medical Schemes at complaints@medicalschemes.com or contact them on, telephone 012 431 0500.

To motivate specific treatments to your medical scheme we may have to provide them with information on your health history and other health information. Should a report be needed, you will need to complete our consent form for release of personal information.

If the person responsible for the account is not available to sign these forms personally, the patient signing these forms admits personal liability for the account.