Tuesday, 21 May, 2024
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SAMA unhappy over medical schemes' low virtual consultation rates

Doctors in private practice, who have already seen a decline in patient visits due to fears of COVID-19 transmission, now face a fresh challenge as medical schemes offer lower reimbursement rates for virtual consultations. Business Day reports that two of South Africa’s leading medical scheme administrators, Discovery Health and Medscheme, have confirmed that they are paying less for telemedicine consultations covered by their client schemes than they do for face-to-face interaction.

The report says the move has upset South Africa’s biggest doctor organisation, the SA Medical Association (SAMA), as its members have already seen their income knocked by a decline in visits to their practices.

Discovery Health, which has 19 client schemes including Discovery Health Medical Scheme (DHMS), said it had set virtual consultation rates at 65% of those usually provided for face-to-face consultations with doctors and specialists.

Medscheme is also paying less for virtual consultations than it does for face-to-face interactions, according to it executive director for healthcare management Lungi Nyathi. Medscheme’s biggest client is the Government Employees Medical Scheme. She said the lower tariff for telemedicine is consistent with international best practice, and is being applied to all the schemes it administers.

According to Business Day, SAMA chair Angelique Coetzee said the organisation’s members are unhappy because medical schemes have not provided a rationale for the lower rate, or indicated a willingness to negotiate.

[link url="https://www.businesslive.co.za/bd/national/health/2020-04-07-doctors-unhappy-about-low-virtual-consultation-rates/?utm_source=&utm_medium=email&utm_campaign=Reserve+Bank+bought+bonds+worth+R1bn+in+March+%7C%C2%A0Mkhize+says+health+workers+will+be+protected+against+Covid-19+%7C%C2%A0UIF%E2%80%99s+R30bn+support+for+workers+hit+by+the+lockdown+is+ready+for+claims&utm_term=http%3A%2F%2Fwww.businesslive.co.za%2Fbd%2Fnational%2Fhealth%2F2020-04-07-doctors-unhappy-about-low-virtual-consultation-rates%2F"]Full Business Day report[/link]

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