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With regard to Designated Service Provider (DSP) Contracts the following law is pertinent for service providers who are not a DSP:
- In terms of Section 59 (2) of the Medical Schemes Act 131 of 1998 the medical scheme must pay valid invoices within 30 days of receipt thereof or advise both the member and service provider of reasons why the invoice is not valid and provide the opportunity to correct the invoice.
- Where services are in respect of medical emergencies or involuntarily obtained services for PMB conditions, the scheme has to pay for the full cost of the services provided without deduction or co-payment or limiting the tariff amount. (Regulation 8 (1) of the Medical Schemes Act no. 131 of 1998.)
- DOH notice 214 of 2021 requires that a scheme pays for services provided at the same rate and in terms of the same rules as they pay their DSPs in respect of services voluntarily obtained, whether they are PMBs or not.
- The process followed in respect of appointing a DSP is required to be fair, equitable, transparent, competitive or cost effective as required in terms of Notice 214 of the DOH.
- The law protects the patient’s choice to use their laboratory of choice, even if it is not a DSP, and the scheme is still obliged to reimburse us at the scheme rate for valid claims.
- This is true for PMB conditions as well as non-PMB conditions.
- The medical scheme must pay valid invoices within 30 days or advise both the member and service provider of reasons why the invoice is not valid and provide the opportunity to correct invoice.
- A scheme must pay for the services provided at a tariff not less than what they would pay a DSP.
- Should any patient have a valid claim rejected because we are not a DSP, we can assist.
Influenza B cases continued to be detected during October with positivity rates reaching 5% in weeks 42 and 43, but remained below the seasonal threshold.
PathCare offers two NIPS products: TriScreen and Panorama
Approximately 10% of all colorectal cancers (CRC) are hereditary. Patients who carry a pathogenic germline variant in a CRC-related gene have an increased risk of developing CRC, as well as other cancers.
When evaluating a patient with abnormal liver functions, it is important to investigate the potential genetic causes
The majority of breast and ovarian cancers are sporadic; however, approximately 5-10% of breast cancers and 10-15% of ovarian cancers are hereditary and passed down through generations.
Your doctor/genetic counsellor has ordered a Centogene genetic test for you or your child through PathCare. Centogene laboratory, based in Germany, will be performing your testing and PathCare is here to coordinate the process
Your doctor/genetic counsellor has ordered an Invitae genetic test for you or your child through PathCare.
Serum-biomarkers of infection such as CRP and ESR and synovial fluid leucocyte count and neutrophil percentage are useful tests to support the diagnosis of PJI. However, it is important to define the infecting micro-organism to direct antimicrobial therapy.
Comprehensive genomic profiling (CGP) is advancing precision oncology through the analysis of multiple relevant biomarkers in a single next-generation sequencing (NGS) test.