GENERAL TERMS AND CONDITIONS
APPLICABLE TO PERSONS JOINING
THIS PRACTICE AS PATIENTS.
Dear Valued Patient
This document explains the general conditions under which this practice
sees patients. It does not constitute an informed consent to any specific
treatment, nor a quotation or price for any service rendered by the practice.
Informed consent and price information will be provided each time you visit
the practice, and will depend on the care you need/seek, and other factors
such as your medical scheme cover.
This serves as a binding contract between you, the patient, and the above
practitioner. You may only sign on behalf of yourself or your dependants
under the age of 18 years or authorized dependants. For patients on medical
scheme plans and over the age of 18 years and registered as dependants on
a medical scheme plan, an individual signature is required on a separate
form as a binding contract with this practice.
In the current medical aid market environment, patients are purchasing
lower cost medical aid plans with restrictive limits on treatment with less
benefits, medicine restrictions, limited hospitalization and surgery cover,
public hospitals as providers of pre-determined treatment and surgical
procedures, and restrictions on access to doctors.
Your treatment, financial costs, and quality of your professional care can
be severely affected by the type of medical plan you belong to and the
generalization of statements such as "100% cover" by your medical aid or
may not correspond with all the aspects of treatment you may require.
These limitations often prove problematic for your doctor as the right to
obtain the necessary professional medical care that meets an acceptable
standard is being influenced by your choice of medical aid cover.
It remains your primary responsibility to familiarize yourself with the
benefits and conditions of your medical aid plan. It is important that you
know your benefit status with regard to the extent of your health cover,
referral restrictions, savings account balances registration and pre-
authorization processes, waiting periods and other requirements. The
Medical Schemes Act 131 of 1998 and its regulations entitle members of
a medical scheme to all information on their benefits and limitations of
their plan. You are responsible to acquaint yourself with the benefits,
insured rates and terms and conditions of your medical scheme plan.
Ascertain the exact amounts your scheme provides for in terms of
consultations, procedures, assistants as well as what your medical aid
will pay and not pay for.
You are obliged to provide your informed consent for any medical
investigation, treatment or procedure to be performed by the doctor. Your
rights obligate the practice to discuss the clinical aspects, financial
implications pertaining to your health status, the diagnostic process as well
as the different treatment options available. You have the right to retract your
informed consent at any stage or to refuse such medical care. Should your
treatment include admission to a healthcare facility where other healthcare
specialists (like anesthesiologists, physiotherapists, etc.) also become
involved in your care and management, you are required to provide
informed consent to their respective treatment and professional fee policies.
Under the provisions of The Children's Act, children may consent to certain
medical treatment from the age of 12 years. Parents / guardians are
however required by law to cover the expenses incurred for the healthcare of
their children. Doctors are obliged to guard the healthcare information of
these children and to keep it confidential and only divulge the information
subject to the child's consent. Please request the practice management staff
to provide examples of these conditions, should you require further
information.
YOUR HEALTHCARE IS IMPORTANT TO US
WHAT DOES YOUR MEDICAL AID COVER?
Practice Details:
Version 4
Where a Designated Service Provider has been appointed by your
medical aid, it remains your responsibility to be cognizant of this and to
bear responsibility for any restrictions that may follow (either medically or
financially) when consulting a non designated doctor or facility.
With ever increasing intervention from your medical scheme, please be
aware that this practice will not allow a medical scheme to violate the
doctor's professional and clinical independence.
Where a medical aid or its advisors intervene to overrule your doctors
preferred diagnostic approach or treatment, your doctor assumes no
responsibility for consequent adverse outcomes. You may be asked to
assume responsibility to the medical aid and it's medical advisors in the
event of complications.
PRE-AUTHORIZATIONS
In the event that hospitalization is required, it remains your responsibility to
ensure that the planned treatment is covered by your medical aid and that
the necessary finances are put in place to cover the non-insured costs.
If pre-authorization is a required for any intervention, it also remains your
responsibility to furnish the practice with the relevant information and
authorization numbers. The practice may assist you in this process
dependant on the individual practice policy. Where your medical aid
questions the appropriateness of your treatment, your doctor may submit a
letter of motivation to the medical scheme if appropriate and may also insist
on a peer-to-peer discussion in above instances.
SETTLING OF ACCOUNTS AND CO-PAYMENTS
To avoid misunderstanding regarding payment policies and to maintain the
professional healthcare standards of this practice, you will be informed of the
current payment options and policies available in the practice.
These fees are determined based upon the appropriateness of the quality
and standard of services rendered. No accounts will be rendered for
services not delivered or delivered to someone else. The practice personal
can inform you if the practice has an agreed policy in place with your medical
scheme, at your request.
This practice reserves the right to claim directly from you in which case you
will be provided with a detailed invoice that is payable to the practice within
30 days from date of service. You have the prerogative to claim this back
from your medical aid. This practice submits accounts subject to the
National Credit Act, The Consumer Protection Act, the Medical Schemes
Act and the guidelines as published by the HPCSA.
This practice reserves the right to charge a service fee for any credit given in
terms of the provisions of the National Credit Act, Act No. 34 of 2005. In
terms of section 101 (1) (c), an initial per transaction service fee may be
charged on the transactions for which a credit amount is provided and
thereafter on a monthly basis for each month a credit balance remains. In
terms of section 101(1)(d), interest may be charged on the account for each
month the credit amount is not paid by you. Where legal action is instigated
for the recuperation of costs for services rendered or goods provided in
terms and associated with the rendered service by this practice then in terms
of section 101 (1) (g) collection costs may be imposed to the extent permitted
by Part C of Chapter 6 of the National Credit Act, Act no 34 of 2005.
You will be informed of the practice billing policy and the prices for services
generally rendered by the practice. Where an exact price cannot be
presented, a quotation aligned with these applicable laws will be provided,
subject to its own terms and conditions. This will be discussed with you at
every visit or treatment event to the practice. Due to the billing policy of the
practice and the fee your medical aid is reimbursing at, a co-payment may
have to be levied by the medical aid or the practice.
Please note: This is a Private Practice.
We DO NOT charge Medical Aid rates
ALL ACCOUNTS TO BE SETTLE WITHIN
30 DAYS OF SERVICE
