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Midmed PMB CDL 2009

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Midmed PMB CDL 2009 Powered By Docstoc
					              MEDISCOR


          Medical Scheme Clients

Scheme Options / Reimbursement Structures /
            General Information

                 March 2011
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011


   MEDICAL SCHEME /             SCHEME OPTIONS       MEDISCOR       DHS           EDI         REIMBURSEMENT STRUCTURE       EXCLUSION CATEGORIES                PAYMENT TO
    ADMINISTRATOR                                    CLAIMING   DESTINATION   ACTIVATION       1.  Pharmacists                                                  PROVIDERS
                                                       CODE        CODE          CODE          2.  Doctors
                                                                                               3.  Unscheduled
                          Blueprint
                          BonusPlus
                          Beat2
                                                                                           1. SEP + 33% / R33 + MRP
                          Beat3                                                                                          Please refer to real-time
                                                                                           2. SEP + 30% / R23.40 + MRP
                          Millennium Comprehensive                               045P                                    response.
BESTmed                                              MDS0027     BEBE0000                  3. SEP + 31% + MRP                                                     BESTmed
                          Topcare
                          Beat1
                          Best Platinum
                          Best Gold
                          Best Gold Select

                                                                                           1. SEP + 26% / R26            1-5,7-9,11,15,17,19-25,27,30-
BCIMAF
                          BCIMAF                     MDS0030     BCIM0001        733P      2. SEP + 30% / R20            32, 36, 40-41,43-45,47-51,53,             BCIMAF
(Status Admin)
                                                                                           3. SEP + 31%                  55,58, 61-62




                          Deluxe                                                           1. SEP + 26% /R26 + MRP        1-9,11,14,15, 17,19-25, 27,
COMMED
                          Standard                   MDS0038     IHCO0000                  2. SEP + 30% / R20 + MRP       30-35, 40,41,43-45, 48,50-               Allcare
(Allcare Admin)                                                                  009P
                          Fundamental                                                      3. SEP + 31% + MRP             51, 55, 56, 58, 60-62




                          Pinnacle
                          Dynamix
                                                                                           1. SEP + 26% / R26 + MRP
COMPCARE                  Mumed                                                                                          3-5, 6-9, 11, 19-25, 27, 30, 32,
                                                     MDS0014     SSCC0000        129P      2. SEP + 30% / R20 + MRP                                         Universal Health Care
(Universal Health Care)   Symmetry                                                                                       40-41, 43-45, 47-51, 60-62
                                                                                           3. SEP + 31% + MRP
                          Axis
                          Networx



                                                                                           1. SEP + 26% R26 + MRP        Restricted to formulary.
DAY 1 HEALTH
                          Day 1 Health               MDS0053     DHEA0004        N/A       2. N/A                        Please refer to real-time            1 Doctor Health
(1 Doctor Health)
                                                                                           3. SEP + 31 % + MRP           response.


                          Momentum Base
                          Thebemed Universal                                                                             Restricted to formulary.
                          OnePlan Core                                           N/A                                     Please refer to real-time
                                                                                           1. SEP + 26% R26 + MRP
FARANANI                  OnePlan Coreplus                                                                               response.
                                                                                           2. N/A
(Faranani Health          OnePlan Elite              MDS0600     FARA0001                                                                                         Mediscor
                                                                                           3. SEP + 31 % + MRP
Solutions)                OnePlan Executive
                          OnePlan Golden Years
                          OnePlan Platinum
                          OnePlan Professional




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011
   MEDICAL SCHEME /                SCHEME OPTIONS   MEDISCOR       DHS           EDI        REIMBURSEMENT STRUCTURE         EXCLUSION CATEGORIES             PAYMENT TO
    ADMINISTRATOR                                   CLAIMING   DESTINATION   ACTIVATION      1.  Pharmacists                                                 PROVIDERS
                                                      CODE        CODE          CODE         2.  Doctors
                                                                                             3.  Unscheduled

                          G500
                          G200
                          B300                                                            1. SEP + 26%/R26 + MRP
GETMED
                          B200                      MDS0060     GETM0001                  2. SEP + 30% / R20 + MRP       6, 37, 40, 50, 51, 62                 Getmed
(Getmed)
                          B100                                                  N/A       3. SEP + 31% + MRP
                          SP500
                          S800
                          Foryou

                                                                                                                         1-11,14-17,19-
                                                                                          1. SEP + 26% R26 + MRP
GOODHOPE MAKOTI           Comprehensive                                                                                  22,24,25,27,28,30-35, 38,40-
                                                    MDS0036     MHPL0001        N/A       2. N/A                                                              Enablemed
(Enablemed Admin)         Primary                                                                                        41,43-45,47,48,50-57,59-
                                                                                          3. SEP + 31 % + MRP
                                                                                                                         60,62-64


                                                                                          1. SEP + 26% / R26 + MMAP
                                                                                                                         1-5, 11,14-15,19-25,27,30-
GRINTEK                                                                                   2. SEP + 30% / R20 + MMAP
                          Grintek                   MDS0065     STGR0000                                                 32,40-41,43-45, 47-51, 53,      Universal Health Care
(Universal Health Care)                                                         259P      3. SEP + 31% + MMAP
                                                                                                                         55,61-62




                          Value Plan                                                      1. SEP + 26% / R26 + MRP       1-5,7-9,11,14,15, 19-25,27,
HOSMED
                          Plus Plan                 MDS0021     THHM0000        523P      2. SEP + 30% / R20 + MRP       30-32, 35, 40,41,43-                   Allcare
(Allcare Admin)
                                                                                          3. SEP + 31% + MRP             45,47,48,51,53,55-57,61,62




                                                                                                                         1-11,14-17,19-
                                                                                          1. SEP + 26% /R26 + MRP
HOSMED STEP PLAN                                                                                                         22,24,25,27,28,30-35,
                          Step                      MDS0061     MHPL0001        N/A       2. N/A                                                              Enablemed
(Enablemed Admin)                                                                                                        38,40,41,43-45,47,48,50-
                                                                                          3. SEP + 31 % + MRP
                                                                                                                         57,59,60,62-64




                                                                                          1. SEP + 26% / R26 + MMAP      1-5,11, 15, 17, 19-25,27,30-
MALCOR                    Malcor A
                                                    MDS0003     NMMD0000                  2. SEP + 30% / R20 + MMAP      32,38,40-41,43-45, 50,51, 53,          Allcare
(Allcare Admin)           Malcor B                                              104P
                                                                                          3. SEP + 26% + MMAP            55,58,60,61
                          Malcor C




                          Medihelp Plus                                                                                  Basic Exclusions
                          Dimension Elite                                                                                4,5,7-9,17, 24-25,27,30-31,
MEDIHELP                                                                                  1. SEP + 26% / R26 + MMAP                                            Medihelp
                          Dimension Prime1          MDS0010     MGFM0001                                                 61-62
(Medihelp)                                                                                2. SEP + 30% / R22.50 + MMAP
                          Dimension Prime2                                      256P                                     Refer to real-time response
                                                                                          3. SEP + 26% / R26 + MMAP
                          Dimension Prime3                                                                               for complete list
                          Necesse




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011
   MEDICAL SCHEME /           SCHEME OPTIONS   MEDISCOR       DHS           EDI         REIMBURSEMENT STRUCTURE              EXCLUSION CATEGORIES               PAYMENT TO
    ADMINISTRATOR                              CLAIMING   DESTINATION   ACTIVATION       1.  Pharmacists                                                        PROVIDERS
                                                 CODE        CODE          CODE          2.  Doctors
                                                                                         3.  Unscheduled


                                                                                     1. SEP + 26% / R26 + MRP             3-5; 7; 11; 19; 22-27; 30; 32;
MIDMED
                                                                                     2. SEP + 30% / R20 + MRP             40; 41; 43-45; 47; 48; 50-53;      Momentum Medical
(Momentum Medical        Midmed                MDS0040    MSAM0002
                                                                           224P      3. SEP + 31% + MRP                               60; 61               Scheme Administrators
Scheme Administrators)



                                                                                     1. New 4 TIER
                                                                                                                          3,5,11,14,15,17,19,20, 22-
                                                                                     2. SEP + 30% / R20
                          SUMMIT                                                                                          28,30-35, 38-41, 43-49,50,52-
                                                                                     3. Pharmacy = SEP + New 4 TIER
                                                                                                                          55,56,59, 60,61, 64
                                                                                        Doctors = SEP + 31%
                                                                                     1. SEP + 26%/R26
                                                                                     2. SEP + 30% / R20                   3,5,11,14,15,17,19,20, 22-
                          EXTENDER                                                   3. SEP + 31%                         28,30-35, 38-41,43-49,50,52-
                                                                                     MHR only applicable to chronic and   55,56,59, 60,61, 64
                                                                                     PMB benefit
                                                                                     1. SEP + 26%/R26
                                                                                     2. SEP + 30% / R20                   3,5,11,14,15,17,19,20, 22-
                           INCENTIVE                                                 3. SEP + 31%                         28,30-35, 38-41,43-49,50,52-
                                                                                     MHR only applicable to chronic and   55,56,59, 60,61, 64
MOMENTUM                                                                             PMB benefit
                                                                                                                                                             Momentum Medical
(Momentum Medical                              MDS0041    MHEA0007                   1. SEP + 26%/R26
                                                                           822P                                                                            Scheme Administrators
Scheme Administrators)                                                               2. SEP + 30% / R20                   3,5,11,14,15,17,19,20, 22-
                           CUSTOM                                                    3. SEP + 31%                         28,30-35, 38-41,43-49,50,52-
                                                                                     MHR only applicable to chronic and   55,56,59, 60,61, 64
                                                                                     PMB benefit
                                                                                     1. SEP + 26%/R26
                                                                                     2. SEP + 30% / R20                   3,5,11,14,15,17,19,20, 28,30-
                           ACCESS                                                    3. SEP + 31%                         35, 38-41,43-49,50,52-
                                                                                     MHR only applicable to chronic and   55,56,59, 60,61, 64
                                                                                     PMB benefit
                                                                                     1. SEP + 26%/R26
                                                                                     2. SEP + 30% / R20                   3,5,11,14,15,17,19,20, 28,30-
                          INGWE                                                      3. SEP + 31%                         35, 38-41,43-49,50,52-
                                                                                     MHR only applicable to chronic and   55,56,59, 60,61, 64
                                                                                     PMB benefit

                         UNIVERSAL CODE:       MDM0000    MCAP0001
MEDICROSS
                         MDM0000


                                                                                     1. SEP + 26%/R26 + MRP
                                                                           N/A       2. SEP + 30%/R20 + MRP
MEDICROSS
                         MOMENTUM – ACCESS     MDM0021     MCAP0001                  3. Pharmacy = SEP+                   CAPITATION PROVIDER                   Medicross
(Capitated Provider)
                                                                                     26%/R26+MRP
                                                                                     4. Doctors = SEP + 30%/R20+MRP




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
  MEDISCOR MEDICAL SCHEME CLIENTS
  SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
  MARCH 2011
   MEDICAL SCHEME /            SCHEME OPTIONS   MEDISCOR        DHS           EDI         REIMBURSEMENT STRUCTURE               EXCLUSION CATEGORIES                PAYMENT TO
    ADMINISTRATOR                               CLAIMING    DESTINATION   ACTIVATION           1.  Pharmacists                                                      PROVIDERS
                                                  CODE         CODE          CODE              2.  Doctors
                                                                                               3.  Unscheduled
                         Classic
MOTO HEALTH CARE         Custom                                                        1. SEP + 26%/R26 + MRP
                                                                                                                             Please refer to real-time           Momentum Medical
(Momentum Medical        Essential              MDS0049     MHCA0001         940P      2. SEP + 30%/R20 + MRP
                                                                                                                             response                          Scheme Administrators
Scheme Administrators)   Hospicare                                                     3. SEP + 31% + MRP
                         Optimum

                                                                                       South African Providers:

                                                                                       1. SEP + 26% / R26 + MRP
                                                                                       2. SEP + 30% / R20 + MRP
                                                                                       3. SEP + 31% + MRP

                                                                                       Namibia Providers:
NAMDEB                   Namdeb                                                                                              4-6, 15, 19, 21-25, 27, 31-32,
(Prosperity Admin)       Namdeb-E                NAM0101                     388P      1. SEP+ 50% mark-up + broken          38, 40-41, 43-45, 50-51, 61-           Prosperity
                                                            RHMS0001
                                                (NAM0001)                              bulk + dispensing and container fee   62
                                                                                       + NRP
                                                                                       2. SEP + 50% mark-up + broken
                                                                                       bulk + dispensing and container fee
                                                                                       + NRP
                                                                                       3. SEP+ 50% mark-up + broken
                                                                                       bulk + dispensing and container fee
                                                                                       + NRP


                                                                                       1. SEP + 26%/R26
                                                                                                                             3-5, 14, 15, 24, 25, 27, 30-32,
Nampak                   Extended                                                      2. SEP + 30% / R20
                                                                                                                             35, 45, 53, 61
(Momentum Medical                                                                      3. SEP + 31%
Scheme Administrators)                                                                                                                                           Momentum Medical
                                                MDS0043     NMAK0000         046P                                                                              Scheme Administrators
                                                                                                                             1-5, 7, 11, 14-16, 19, 20, 22-
                         Standard                                                      1. SEP + 26%/R26 + MMAP
                                                                                                                             25, 27, 30-32, 35, 40, 41, 43-
                                                                                       2. SEP + 30% / R20 + MMAP
                                                                                                                             45, 49-51, 53, 55, 57, 58, 61
                                                                                       3. SEP + 31% + MMAP


                                                                                       South African Providers:

                                                                                       1. SEP + 26%/R26 + NRP
                                                                                       2. SEP + 30% / R20 + NRP
                                                                                       3. SEP + 31% + NRP

                                                                                       Namibia Providers:
NAPOTEL                  Napotel
                                                 NAM0102                                                                     3-9, 11, 15, 17, 19, 22-25, 27,
(Prosperity Admin)       Napotel-Topup                      RHMS0001         388P      1. SEP+ 50% mark-up + broken                                                 Prosperity
                                                (NAM0002)                                                                    31-32, 44, 61-62
                                                                                       bulk + dispensing and container fee
                                                                                       + NRP
                                                                                       2. SEP + 50% mark-up + broken
                                                                                       bulk + dispensing and container fee
                                                                                       + NRP
                                                                                       3. SEP+ 50% mark-up + broken
                                                                                       bulk + dispensing and container fee
                                                                                       + NRP




PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011




   MEDICAL SCHEME /              SCHEME OPTIONS   MEDISCOR        DHS           EDI           REIMBURSEMENT STRUCTURE             EXCLUSION CATEGORIES               PAYMENT TO
    ADMINISTRATOR                                 CLAIMING    DESTINATION   ACTIVATION         1.  Pharmacists                                                       PROVIDERS
                                                    CODE         CODE          CODE            2.  Doctors
                                                                                               3.  Unscheduled

                                                                                         1.   SEP + 26%/R26 + MMAP
NETCARE
                                                                                         2.   SEP + 30% / R20 + MMAP           3-5,14,15,24-25,27,30-             Momentum Medical
(Momentum Medical        Netcare                  MDS0046      NPMS0000        067P
                                                                                         3.   SEP + 31% + MMAP                 32,35,45,53,61                   Scheme Administrators
Scheme Administrators)


                                                                                         1.   SEP + 26% /R26 + MRP
                                                                                         2.   SEP + 30% / R20 + MRP            1-9, 11, 14-16, 19-27, 30-32,
                         Opmed                    MDS0050      NASE0000                                                                                               Mediscor
OPMED                                                                          142P      3.   SEP + 31% + MRP                  40-45, 50-51, 58, 61-62
(Opmed)


PG GROUP                                                                                 1.   SEP + 26%/R26 + MMAP
(Momentum Medical                                                              146P      2.   SEP + 30% / R20 + MMAP           3-5, 14-15, 24-25, 27, 30-32,      Momentum Medical
                         PG Group                 MDS0045      NMPS0000
Scheme Administrators)                                                                   3.   SEP + 31% + MMAP                 35, 45, 53, 61                   Scheme Administrators




                                                                                         South African Providers:

                                                                                         1. SEP + 26%/R26 + MRP
                                                                                         2. SEP + 30% / R20 + MRP
                                                                                         3. SEP + 31% + MRP
PROSPERITY LIFE
                         Oxygen
NAMIBIA                                                                        388P      Namibia Providers:
                         Studentstd
(Prosperity Admin)                                 NAM0105
                         Execumed                              RHMS0001
                                                  (NAM0005)                              1. SEP+ 50% mark-up + broken          1-6, 15, 19, 20-27, 31-35, 42,
                         Vitality                                                                                                                                    Prosperity
                                                                                         bulk + dispensing and container fee   44-45, 57-58, 60-62
                                                                                         + NRP
                                                                                         2. SEP + 50% mark-up + broken
                                                                                         bulk + dispensing and container fee
                                                                                         + NRP
                                                                                         3. SEP+ 50% mark-up + broken
                                                                                         bulk + dispensing and container fee
                                                                                         + NRP


                                                                                         1.   SEP + 26% /R26 + MRP             1-5,9,11,14,15,19-25,27,30-
PG BISON
                         PG Bison                 MDS0017     DEAN0000         N/A       2.   SEP + 30% / R20 + MRP            32,36,40, 43,45,47,48,50,               Allcare
(Allcare Admin)
                                                                                         3.   SEP + 31% + MRP                  51,61,62




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011
   MEDICAL SCHEME /             SCHEME OPTIONS     MEDISCOR        DHS           EDI           REIMBURSEMENT STRUCTURE             EXCLUSION CATEGORIES            PAYMENT TO
    ADMINISTRATOR                                  CLAIMING    DESTINATION   ACTIVATION         1.  Pharmacists                                                    PROVIDERS
                                                     CODE         CODE          CODE            2.  Doctors
                                                                                                3.  Unscheduled



PHAROS                   Footprint Comprehensive
(Private Health Admin)   Footprint Primary
                         Methcare                                                         1.   SEP + 26% /R26 + MRP             3-7,11,14, 15,19,21-
                         Paladin Comprehensive     MDS0016      PVPH0000        583P      2.   SEP + 30% / R20 + MRP            25,27,30,31,40,41, 43-45, 48,   Private Healthcare
                         Rainbow Comprehensive                                            3.   SEP + 31% + MRP                  50, 51, 61,62
                         Rainbow Primary
                         Rainbow Plus




                                                                                          South African Providers:

                                                                                          1. SEP + 26%/R26 + MRP
                                                                                          2. SEP + 30% / R20 + MRP
                                                                                          3. SEP + 31% + MRP
                         Plan A
                         Plan B                                                           Namibia Providers:
ROAD CONTRACTORS         Plan C
COMPANY                  Plan D                     NAM0103                               1. SEP+ 50% mark-up + broken          1-11, 15, 17, 19, 22-25, 27,
                                                                                                                                                                   Prosperity
(Prosperity Admin)       Plan A-Topup              (NAM0003)   RHMS0001         388P      bulk + dispensing and container fee   31-35, 44-45, 58, 61-62
                         Plan B-Topup                                                     + NRP
                         PlanC-Topup                                                      2. SEP + 50% mark-up + broken
                         Plan D-Topup                                                     bulk + dispensing and container fee
                                                                                          + NRP
                                                                                          3. SEP+ 50% mark-up + broken
                                                                                          bulk + dispensing and container fee
                                                                                          + NRP


                                                                                          South African Providers:
                         Access
                         Econo                                                            1. SEP + 26%/R26 + MRP
RENAISSANCE HEALTH       Elite                                                            2. SEP + 30% / R20 + MRP
MEDICAL AID FUND         Express                                                388P      3. SEP + 31% + MRP
NAMIBIA                  Overberg
(Prosperity Admin)       Prestige                                                         Namibia Providers:
                         Primary
                                                    NAM0104                                                                     2, 4-5, 15, 21-27, 31-32, 35,
                         Status                                RHMS0001                   1. SEP+ 50% mark-up + broken                                             Prosperity
                                                   (NAM0004)                                                                    44-45, 58, 60-61
                         Vitality Daycare                                                 bulk + dispensing and container fee
                         Keycare                                                          + NRP
                                                                                          2. SEP + 50% mark-up + broken
                                                                                          bulk + dispensing and container fee
                                                                                          + NRP
                                                                                          3. SEP+ 50% mark-up + broken
                                                                                          bulk + dispensing and container fee
                                                                                          + NRP

                         Selfmed 80
                                                                                                                                3-5, 7-9, 11, 14,-16, 19-25,
SELFMED                  Medelite                                                         1. SEP + 26% R26 + MRP
                                                                                                                                27, 30-32, 35, 41, 45, 47-49,
(Selfmed)                Selfsure                  MDS0052      SHSF0000        004P      2. SEP + 30% / R23.40 + MRP                                                Selfmed
                                                                                                                                51, 53, 60-61
                         MedXXI                                                           3. SEP + 31 % + MRP




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
   MEDISCOR MEDICAL SCHEME CLIENTS
   SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
   MARCH 2011
   MEDICAL SCHEME /                 SCHEME OPTIONS    MEDISCOR       DHS           EDI         REIMBURSEMENT STRUCTURE              EXCLUSION CATEGORIES                 PAYMENT TO
    ADMINISTRATOR                                     CLAIMING   DESTINATION   ACTIVATION        1.   Pharmacists                                                        PROVIDERS
                                                        CODE        CODE          CODE           2.   Doctors
                                                                                                 3.   Unscheduled
                                                                                            1. SEP + 26%/R26 + MRP
                          COBALT                                                            2. SEP + 30% / R23.40 + MRP           2, 3, 4, 5, 7, 8, 9, 10, 11, 14,
SPECTRAMED                AZURE                                                             3. SEP + 31% + MRP                   15, 16, 19, 20, 21, 22, 23, 24,
(Vmed)                    CAPRI                                                   522P                                           25, 26, 27, 30, 31, 32, 35, 40,
                                                      MDS0062     ROSP0000                                                                                                  Vmed
                          CYAN                                                              * FRP applicable to PMB medication   41, 43, 44, 45, 47, 48, 50, 51,
                          AQUA                                                              * FRP Plus applicable to PMB                    53, 60, 61.
                                                                                              medication on the COBALT and
                                                                                              AZURE option.

THEBEMED
(Thebe Ya Bophelo         Energy                                                            1.   SEP + 26% /R26 + MRP
                                                                                                                                 1-9,11,14-15,17, 19-28,30-
Admin)                    Navigator                   MDS0033     TBEN0001        769P      2.   SEP + 30% / R20 + MRP                                                Thebe Ya Bophelo
                                                                                                                                 32,40-41, 45,47-48
                          Universal                                                         3.   SEP + 31% + MRP




TIGER BRANDS              Tiger A                                                           1.   SEP + 26% /R26 + MMAP
                                                      MDS0064      TIGE0000                                                      1-6,7-11,14-15, 19,21-25, 27,
(Universal Health Care)   Tiger B                                                 228P      2.   SEP + 30% / R20 + MMAP                                              Universal Health Care
                                                                                                                                 30-32,41, 43-45,48, 58,61-62
                          Tiger C                                                           3.   SEP + 31% + MMAP


                                                                                                                                 3,4,5, 11, 14, 15, 16, 19, 20 -
                                                                                                                                 25, 27, 30, 31, 32, 35, 38, 40,
                          Topmed Incentive
                                                                                                                                 41, 43, 44, 45, 48, 51, 52, 53,
                          Comprehensive
TOPMED                                                                                      1.   SEP + 26% /R26 + MMAP                   55, 60, 61, 64
                          Topmed Hospital                                                                                                                             Momentum Medical
(Momentum Medical                                     MDS0048      BKTE0001       003P      2.   SEP + 30% / R20 + MMAP
                          Topmed Network                                                                                                                             Scheme Administrator
Scheme Administrators)                                                                      3.   SEP + 31% + MMAP                Incentive Comprehensive /
                          Topmed Incentive Savings
                                                                                                                                 Incentive Savings
                          Topmed 80%
                                                                                                                                 60, 64, 61


Umvuzo                                                                                      1.   SEP + 26% / R26 + MRP
                          Standard                                                                                               Please refer to real-time              Umvuzo Health
(Umvuzo Health                                        MDS0059      UHMS0001                 2.   SEP + 30% / R20 + MRP
                          Ultra Affordable                                        N/A                                            response                               Managedcared
Managedcare)                                                                                3.   SEP + 31% + MRP
                          Supreme
PRIMECURE                 MEDISCOR UNIVERSAL CODE:
                                                      MDS0300    PCUR0001
                          MDS0300

                          ANGLOMED                    MDS0353

                          BESTMED                     MDS0302

                          BONITAS (Boncap)            MDS0344                   642P

PRIME CURE                EYETHUMED                   MDS0305                               1. SEP + 26% / R26 + MRP
                                                                   PCUR0001
                                                                                            2. SEP + 30% / R20 + MRP             CAPITATION PROVIDER                      Prime Cure
(Capitation Provider)     FURNMED                     MDS0306                               3. SEP + 31% + MRP

                          G4S                         MDS0349

                          GOLDFIELDS MEDICAL SCHEME   MDS0354

                          MINEMED                     MDS0342




 PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT
 MEDISCOR MEDICAL SCHEME CLIENTS
 SCHEME OPTIONS / REIMBURSEMENT STRUCTURES / GENERAL INFORMATION
 MARCH 2011
                MOMENTUM HEALTH          MDS0355

                PRIME CURE ALL OPTIONS   MDS0300

                SUREMED                  MDS0347

                SUREONE                  MDS0336

                TLAKANO                  MDS0356

                TRANSMED                 MDS0317

                UMVUZO HEALTH            MDS0331

                WORLD VISION             MDS0348




PLEASE NOTE: All reimbursement values reflected in this document are EXCLUSIVE OF VAT

				
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