Billing Policy

Dear Patient

As a medical practice, we always focus on medical care as our primary responsibility. We enjoy our work and see this as a profession and a calling. We pride ourselves on our dedication and hard work. We always strive for excellence in every aspect of our care.

This said it is not possible to run a medical practice successfully at current medical aid base rates. Our practice is not contracted with medical aids for any outpatient work, and we only have a contract with Discovery Classic contracts for inpatient work.

We understand that some patients do not have the financial means to cover medical expenses. We feel morally and ethically compelled to extend discounts or down payments to all patients who request further help in this regard.

Please contact DMS/Spesprac directly to arrange a discount or down payment if required:

Info@spesprac.co.za or phone 021 827 1434.

Thank you.

Werner von Zeuner

SUMMARY:

This practice asks above medical aid base rate.

Our fees are in line with industry standards and independent business recommendations.

We bill all legal codes approved by the Health Professional Council of South Africa: These include all consultations and special investigations. Further approved codes include written prescriptions, motivation letters, and family counseling/education. 

We do not have a contract with any medical aid for outpatient work.

We have a contract with Discovery Classic plans for inpatient work.

We offer discounts or down payments to all patients with financial limitations.

COMMUNICATION:

DMS/Spesprac: Info@spesprac.co.za or phone 021 827 1434.

PRACTICAL: WHAT TO DO NEXT:

Outpatient work/Outpatient consultations:

Your account will be submitted to the medical aid. Short payments will be communicated via DMS/Spesprac our third party for billing-related work. Please contact them directly for discounts or down payments.

Inpatient work/Inpatient consultations/Hospital work:

Your account will be submitted to the medical aid on discharge. This will be the full quote.

We expect a turnaround period of 2 – 3 weeks from the medical aid.

DMS/Spesprac will ask the account to be reviewed if a short payment is received. This can take another 2 – 3 weeks. For all PMB conditions and Emergency care, we will submit a motivation letter to request full coverage of your inpatient fees.

If after this there is still a short payment you will need to communicate with DMS/Spesprac concerning discounts or a down payment.

NB: If your admission was a true emergency for a PMB condition, your medical aid should cover your fee in full. Our practice fees are within the legal limits obligated by the Council for Medical schemes. If your medical aid does not follow the Council's instructions, you can contact them regarding a review or complaint.

Council for Medical Schemes: information@medicalschemes.co.za or phone them +27 86 112 3267

INSURANCE CLAIMS AND RELATED WORK:

All insurance claims are for the patient's bill and will be claimed on completion of the task. These fees are according to fixed remuneration and no discounts apply.