A COVID Christmas from Qualicare
By the time you receive this newsletter, Covid 19 will have again taken hold in the Western Cape. The fears of the doctors, patients and public will accelerate as we approach Xmas and the perceived family gatherings and interprovincial travel.
With this in mind, you will find a poster for your surgery window and front door, which many of our practices have used successfully in the first wave stating:
“No mask, No Entry”.
Remember that the Council for Medical Schemes has clearly stated that Medical Aids are OBLIGED to pay for PPE from their risk pool , backdated to 7 May 2020, and going forward. This covers all patients on all Medical aid plans, with suspected as well as with proven Covid.
It is our contention that every patient who comes in with any of the symptoms of Covid, which are shared by other SARS and less onerous virus families, will qualify for the patient to be a suspected Covid patient. It is NOT an automatic requirement that the patient must then be sent for a Covid test to disprove the diagnosis IF, after thorough assessment, you do not feel that the patient has Covid. In our opinion, as long as the patient was suspected of having Covid when they approach you for an assessment, you HAD to wear PPE and that PPE MUST be paid for by the Funders from their risk pool.
Please REPORT all funders who do not comply with their PMB Covid 19 responsibility to us at CPC/Qualicare and we will escalate these complaints to the CMS, should the funders remain intransigent.
Finally COIDA for Covid:
Employees of a doctor are entitled to claim COIDA assistance etc should they contend that that they contracted the disease at work.
You, as the employer are expected to merely complete the employers report without adjudicating the merits of the claim. The latter is the duty of the Commissioner and not the employer.
Do not get onto a situation where you become involved in deciding whether the claim has merit of not.
The staff member can go to any doctor of their choice to complete the WCL4 form, and may also elect to choose you to do this.
Remember however that if the Commissioner rejects the case:
- The staff members gets no financial reward from the Commissioner
- The doctor completing the WCL4 does not get paid.
- The staff member will probably then have to use their own sick leave if they have any left in that leave cycle.
Tariffs for 2020 :
In a repeat of their behaviour of years gone by the majority of funders have, once again, failed to advise the profession timeously of the rates for 2020.
We have however received the offerings of the Funders below, reproduce them merely for your information and thank them most sincerely for their consideration.
Please note well that we neither negotiate, recommend, endorse, encourage or reject these rates, and have had no part in their compilation or setting.
Best wishes and Warm regards
Tony Behrman and the QC Team