South African Medical Association

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PP4U: COMPENSATION FUND TO IMPLEMENT MANAGED CARE PROCESSES

 
 
 

COMPENSATION FUND TO IMPLEMENT MANAGED CARE PROCESSES

The Compensation Fund has advised that they will begin to implement managed care within its processes in order to curb rising medical and related costs and improve co-ordination of care of beneficiaries.

The attached communique from COID provides the details of which services will be automatically authorised as well as where pre-authorisation will be required.

The operational requirements of this system e.g. how applications will work and where these need to be processed is not clear from this communique but SAMA Private Practice Department will continue to work to better understand what the requirements of this new managed care system will entail

Please do take note of the specifics of the communique if you are involved in the care of patients claiming from the Compensation Fund

Regards
SAMA Private Practice Department

 

COID memo to medical service providers
 

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