Knowledge Hub
Categories:
- Allergy [1]
- Antimicrobials & infection [5]
- Autoimmune [1]
- Chemical Pathology [15]
- Endocrinology [1]
- Epidemiology [3]
- Gastrointestinal [2]
- Genetics [6]
- Genitourinary [2]
- Haematology [9]
- HIV/TB [3]
- Infectious Diseases [10]
- Neurology [4]
- Obstetric and Neonatal care [4]
- Oncology [1]
- Ophthalmology [1]
- Respiratory [2]
- Serology [3]
- Virology [44]
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.
In summary:
- 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.
PathCare Send Away Service to Molecular Neuropathology Division
PathCare has recently set up an efficient send away service for neuropathology molecular requests. This is to improve our test menu for this rapidly growing and specialised field as well as to improve the turn around time of tests such as MGMT promoter methylation.
IDYLLA: Advances in Single-Gene Testing for precision oncology
Rapid advances in the understanding of solid tumours has lead to exponential growth in the developement of molecularly-targeted therapies. Patients with tumours harbouring specific mutations may be candidates for specific therapies.
BRCAPlus Somatic NGS Panel
The PathCare molecular laboratory is pleased to announce a new in-house NGS assay designed to have specific relevance in targeted therapy for ovarian, breast, prostate and pancreatic carcinoma.
Respiratory Virus Statistics: May 2022
The National Institute for Communicable Diseases declared the start of the influenza season in week 17 (week ending 1 May) and influenza A positivity rates have continued to increase during May 2022, reaching 36.1% during week 22 nationally (week ending 5 June). Influenza B detection rates remain low.
Monkeypox Guidance for Clinicians
With the identification of cases of monkeypox in various non-endemic countries since early May 2022, heightened vigilance is required in order to contain the spread of this virus. Monkeypox virus is transmitted by contact with infected animals or humans, or other contaminated material.
Global shortage of Betanoid Tablets
There is currently a global stock shortage of Betanoid (betamethasone) tablets. Betanoid is used in the Dexamethasone Suppression Test for screening of Cushing’s Syndrome. PathCare will, until further notice, be unable to supply patients with Betanoid tablets.
Update: BioFire Filmarray Syndromic Panels
Testing for respiratory pathogens using comprehensive multiplex molecular panels has become a valuable diagnostic tool to assist in early identification of causative organisms. Appropriate use supports timely and directed antimicrobial therapy, especially for organisms that cannot be cultured routinely (e.g Mycoplasma, Legionella, Chlamydophila, Bordetella and viruses); decreases in-hospital admission rate, length of hospital stay, and also assists in antimicrobial stewardship by avoiding the use of empiric antimicrobial agents.
Respiratory Virus Statistics: Jan – April 2022
The National Institute for Communicable Diseases declared the start of the respiratory syncytial virus (RSV) season in week 7 (week ending 20 February) and the positivity rate has continued to increase through March and April.
Typhoid/Salmonella Testing
Enteric fever includes typhoid fever (an infection caused by Salmonella enterica serotype Typhi) and paratyphoid fever (infections caused by Salmonella enterica subspecies enterica serotypes Paratyphi A, B or rarely, C) Paratyphoid fever is clinically indistinguishable from typhoid fever and the diagnosis and clinical management is identical. In South Africa, enteric fever is a notifiable condition with epidemic potential.