Let us assist in making your interaction with healthcare professionals easier

Until a few years ago it was very easy to determine how much healthcare professionals would charge and whether your medical aid will pay for it. Until 2004 there were private rates and medical aid rates. If the healthcare professional charged medical aid rates your consultation would have been paid in full and if it were private rates you would have a co-payment of some sort. However in 2004 the Competition Commission ruled that this practise is a form of price fixing and it was declared illegal. It is here that payment for healthcare professionals turned into a nightmare for all role players in the healthcare industry.

In an effort to give some sort of guidance to the industry, the national Department of Health issued the National Health Reference Price List (NHRPL) which gave a guideline of what should be charged for a particular health service.

While many healthcare professionals use this as their billing guideline, many others will charge up to five times the value stated in this handbook. Unfortunately there is nothing consumers or medical aids can do to these prices, how high they might seem because they are free to charge whatever they think is fair.

Very few medical aids can afford to pay the healthcare professional's bill in full as it will have a disastrous effect on the medical aid. Therefore many medical aids have a specified rate of what they will pay for a specific healthcare service which may be the same or based on the NHRPL.

At Interhealth Technologies we understand that this can be utterly confusing to patients and sometimes result in enormous co-payments. In an effort to assist patients as well as healthcare professionals we have formed local networks where patients will know upfront how much they will pay for a service and doctors will know that they will be paid at the rate they request.

Let us make your life easier and assist with your medical bills and interaction with healthcare professionals.

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