We charge NHRPL rates which is the national government gazette rate. NHRPL rates are regulated by the board of healthcare funders.
A medical aid rate is the rate at which your medical aid reimburses a claim, which is not necessarily NHRPL rates. Medical schemes determine their own specified rate at which they will pay for a claim. This will reflect in the annual prospectus you receive from your medical scheme. You, as the member of the medical aid and our valued patient, have to familiarise yourself with these rates prior to your visit to our practice. We therefore cannot guarantee that your claim will be covered in full by your medical scheme.
Below are all the medical aid schemes we contract out to: However, the onus is still on the patient to confirm with their medical scheme whether we are indeed allowed to treat them and if we are a preferred network provider.
Bankmed (not Basic Opt)
Cape Medical Plan
De Caan Services
L.A. Health (not Keycare)
NBC Pure Health
Old Mutual (Oxygen)
Pharos (B.I. Solutions)
Unfortunately, we DON’T contract out to patients belonging to Allcare and all the medical aids administered by DENTAL RISK COMPANY (012 741 5101 or e-mail firstname.lastname@example.org to confirm network providers). These include patients belonging to the following medical schemes: Affinity Health; GetSavvi; DRUM; Stratum; Medicall; Eminent; Profmed; MediHelp; Topmed; Wesmart; National Health Care & EEBS. Also Ingwe Health Plan; One Care; Sigma; Medical Waste Bin; Medicover; Malcor; Medcor; Medicor; Medicross & Global Health. Patients belonging to DISCOVERY HEALTH, but who are on the following options all fall under DRC: All the Keycare options; Remedi; Bankmed Basic; Anglo Med Std Core; TFG; Primary Care; LA Health Focus.