Medical Schemes Act 131 Of 1998 - Charges By Suppliers Of Service
The ombudsman, Dr L Blum reports that there are several members
who do not render an account to a patient where the same account is being submitted to the
patient's insurance scheme.
Dr Blum has been inundated with calls from patients who are not furnished with a
full statement and only discover the amount of the claim when they receive a claims
summary or statement from their medical scheme.
It is submitted that this reflects poorly on the dental profession and not in
accordance with the provisions of s 59 of the Medical Scheme Act.
In terms s 59 (1) of Act 131 of 1998
a supplier of service who has rendered a service to a member
or his or her dependant is required to furnish to the member an account or statement
reflecting such particulars as prescribed.
It is therefore imperative that even where dentists submit their
accounts or statements directly to medical schemes of patients, they must nevertheless
furnish the patient with a copy of such account or statement giving full particulars of
the treatment rendered and the costs thereof.
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