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.
Retesting after a positive PCR outcome for SARS-CoV-2
The presence of viral RNA in respiratory samples is critical information in the diagnosis of an acute SARS-COV-2 infection. The real-time reverse transcription-polymerase chain reaction (RT-PCR) detects these pieces of RNA. But RT-PCR is a poor test of cure. The presence of RNA does not imply the presence of infectious or replication-competent virus.
COVID-19 Antibody Testing now available
COVID-19 Antibody testing available at PathCare
Western Cape Province Antimicrobial Surveillance Data
We have updated the PathCare susceptibility data for common community-acquired organisms isolated from patients in the Western Cape Province from the first of March 2019 until the end of February 2020
COVID-19 ANTIBODY TEST
In response to the many questions being asked of us as to when we would be able to offer antibody testing; this is a brief note of explanation as to the processes we have to follow before we may offer the tests.
Coronavirus
PathCare now offers SARS-CoV-2 / COVID-19 testing
On 31 December 2019, the World Health Organization (WHO) China country office reported a cluster of pneumonia cases in Wuhan City, Hubei Province of China. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been confirmed as the causative virus of Coronavirus disease 2019 (COVID-19). This virus has since spread to all continents and South Africa’s first case was identified on 5 March 2020.
Umbilical Cord Blood Gas Analysis
Cord blood gas analysis is considered the gold standard for the determination of intrapartum foetal hypoxia. It provides an objective retrospective method for continuous quality improvement in the management of foetal acid-base abnormalities. It is also sensible to keep normal blood gas results on record for a baby with an uneventful delivery, but who may develop neurological impairment later.
Lymphocytosis: Causes & approach to evaluation in adults
Lymphocytosis refers to an increase of peripheral blood lymphocytes, which for adults is defined as an absolute lymphocyte count (ALC) > 4.0 x 109 /L. Lymphocytes generally constitute 8-33% of white blood cell count (WBC) in peripheral blood. The normal number and distribution of lymphocyte subsets vary with age.
Platform change for urine cortisol analysis
Please take note of the platform change for 24 hour urine cortisol analysis.
This test will now be performed on the Abbott Architect immunoassay platform and will result in a change in reference interval to:
24 hr urine cortisol reference interval: 11.8 – 485.6 nmol/24 hours
Non-payment for syndromic PCR testing (BioFire FilmArray)
We write to you to keep you informed of developments within the medial scheme industry that affect the funding of some tests, specifically BioFire, used for diagnosis in acute respiratory diseases, suspected meningitis/encephalitis and diarrhoeal disease for the rapid identification of the pathogenic cause.