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.
Hyperuricaemia and Gout: Important Lessons to be Learnt
Gout is a common clinical disease and, furthermore, it is readily treatable and managed by the long-term use of urate lowering medication. Gout, the clinical syndrome, needs to be distinguished from hyperuricaemia which refers to the increased levels of serum urate.
Frequently asked questions: SARS-CoV-2 B.1.1.529/Omicron variant
On 26 November 2021 the WHO designated the new SARS-CoV-2 lineage B.1.1.529, now named Omicron, a variant of concern.
Much is still unknown about Omicron and it is expected that the variant’s real world impact will become clearer over the next weeks.
Covid-19 associated pulmonary aspergillosis (CAPA)
In individuals with co-morbidities, defective immune responses to SARS-CoV-2 may allow unrestricted viral replication which elicits hyperinflammation and severe complications such as acute respiratory distress syndrome (ARDS).
COVID-19 resulting in ARDS has recently emerged as an important disease that predisposes patients to secondary pulmonary aspergillosis.
Advances in molecular oncology: Liquid biopsy for non-small cell lung cancer
In recent years, liquid biopsies have emerged as a promising tool in the fields of molecular oncology and precision medicine. Liquid biopsy methodology typically analyses genomic DNA isolated from circulating tumour cells (CTCs) or circulating cell-free tumour DNA (cfDNA/ctDNA) in a peripheral blood sample, to gain insight into the genomic profile of the patients’ tumour.
Polymyxin guidelines
Due to a rapid increase in serious infections related to especially carbapenemase producing Enterobacterales, the clinical use of the polymyxin antibiotics colistin (polymyxin E), and polymyxin B has recently resurged as salvage therapy for otherwise untreatable Gram-negative infections.
Hepatitis E: Is this Virus Relevant in Southern Africa?
A fairly recent article on the nationwide outbreak of Hepatitis E (HEV) in informal settlements in Namibia as well as the recent academic interest in this previously mostly ignored virus, prompted this EduPath.
Serological assays for SARS-COV-2 vaccine responses
PathCare has introduced an antibody test that is capable of detecting antibodies directed against the SARS-CoV-2 spike (“S”) protein, induced by SARS-CoV-2 vaccines or by natural infection
Update on molecular testing for respiratory pathogens
Testing for respiratory pathogens using comprehensive multiplex molecular panels have 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 routinely cultured (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
Diabetes Antibodies
Immune-mediated diabetes is characterized by the presence of circulating specific antibodies against the pancreatic islets such as glutamic acid decarboxylase autoantibodies (GADA), islet antigen-2 autoantibodies (IA-2A), or zinc transporter-8 autoantibodies (ZnT8A).