Compensation for Occasionally Disbursed Accounts ( COIDA )
With great fanfare, the COIDA roadshow took to the streets 2 months ago with an amazing electronic system which would log, adjudicate and pay your COIDA claims within a jiffy.
When asked what they were doing about the backlog amounting to approx. R3000 for every practitioner in the Western Cape (whether they do COIDA cases or not) this was dismissed as an unpatriotic question and they were here to show us the solution, not dig up the past.
In the interim, based on the horrendous legacy of the COIDA of non-payment of accounts to practitioners, CPC/Qualicare took the matter to Parliament, where an official question was posed, and a time line set, that within 60 days, the minister of labor must report back to the House on the progress of answering the question.
Needless to say, this deadline was ignored, but the Auditor general has now stepped in an qualified the COIDAs audit, as it has been for the past 7 years. It is believed now that the matter has been raised to such a high profile, that action must now be forthcoming.
A symptom of the immorality of the current situation is the development and of highly profitable, and avaricious intermediaries in the COIDA system. These rogue forces, take your claims, pay you a reduced % of their face value, then place them before corrupt, bribed officials in the COIDA accounts Department, where it is reported, the claims are almost certainly inflated, passed for payment over to the third party, who pockets 35 % of your inflated claim. It goes without saying that all other legitimate claims in the payments queue are just relegated to the proverbial bottom of the pile thereby enhancing your dependence on the intermediaries. Cocaine is sold in the same way!!
Hospitals and high income earners are the biggest users of the irregular chain of accounts processing at COIDA, but Family Practitioners too support the system, out of a mixture of frustration with the non-working regular channels, and greed, using the age old adage which has sunk generations of weak will practitioners in the past,” something is better than nothing”.
Qualicare is determined to FIX THE SYSTEM by exposing it and will continue to push this matter to fruition, but in the interim warns you all that sharing of fees with third parties is an Ethical transgression and carries severe sanction from the HPCSA. Using these intermediaries’ amounts to illegal fee sharing!!
On the other hand we cannot blame large numbers of doctors who merely offer emergency treatment to COIDA victims, and send them off into the sadly equally inefficient state sector. At least they do not have to pay VAT over on monies which they will never receive!
As for the new electronic system of COIDA, we believe that it has already fallen over!!!
Share and Share alike:
So here comes this hot shot businessman which what sounds like a great proposal for a young GP /FP starting out.
I will give you everything you need to start and run a practice. I will set it all up, run the business for you, do the accounts for you, hire and fire the staff for you etc etc . All you need to do is see the patients on your practice number, and link that number to the businessman’s bank account.
All your consultation, procedure and medicine money will come into his account, he will reconcile all of the payments from the funders, and will pay you a salary, which he might even base upon your turnover.
Sound idyllic? No responsibilities, no bad debts, no accounting queries etc etc Why on earth not do it?
Truth of the matter is this is once again fee sharing as well as account fraud.
The businessman skilfully manipulates your accounts, the final version of which you never see, substitutes, fee farms, and amends them, then banks all of the money due to your practice number into his account.
These scams have been around for years, but Qualicare has once again been tipped off that they have resurfaced.
YOU HAVE BEEN WARNED!!!
IPAF educational grant.
The IPAF has been placed in a position to entertain requests from all Family Practitioners to study allopathic up skilling courses, (IPA aligned or not), in an attempt to raise the Family Practitioners game.
IPAF understands that the FPs must take on more responsibility, utilise more skills in Family practice, and in general up his game to rise to the need for FPs to be the first port of call of all patients.
The funders have finally understood the error of their ways of encouraging direct access to specialists, and most self-respecting schemes now insist that the GP/FP initiates the chain of interventions AND remains in control of the patient until cured.
Astra Zeneca shares this vision with the IPAF and has funded this no strings attached grant which is run through IPAF.