Discovery Health

 

Billions are lost due to Doctors, hospitals and medical aid members collude to commit fraud

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The Special Investigating Unit says it is actively targeting fraudsters in the private healthcare sector.

Fraud, waste and abuse is costing the private healthcare system more than R22-billion, and if you submit false claims, you could face more than just being terminated from your scheme, the Council for Medical Schemes warned at its summit on fraud this week.

The event comes after deputy president David Mabuza announced at the Presidential Health Summit that the Special Investigating Unit (SIU) would be honing in on the healthcare sector.

“We want independent investigations that are turned around quickly and submit and identify findings appropriately,” Mabuza said at the October gathering.

The CMS estimates that fraud, abuse or waste accounts for about 15% of the R160-billion in claims that medical aids pay out annually.

The head of the SIU, advocate Andy Mothibi, said the body is working with the National Prosecuting Authority to help ensure tha
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Discovery apparently is more focused on profit than on service delivery to patients – patients signing in at certain hospitals now have to pay an extra R5000

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Discovery apparently is more focused on profit than on service delivery to patients - patients signing in at certain hospitals now have to pay an extra R5000

Discovery’s medical scheme announced at a very late stage that patients signing in at certain hospitals would have to pay an extra R5000 or go to an approved clinic. The arrangement will be implemented from February 1, 2019 and doctors are not happy with the announcement. Experts point out that the medical scheme is apparently..
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Discovery klaarblyklik meer ingestel is op winsbejag as op dienslewering aan pasiënte – pasiënte wat by sekere hospitale inteken moet nou ‘n ekstra R5000 opdok

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Die mediese skema Discovery het op ‘n baie laat stadium aangekondig dat pasiënte wat by sekere hospitale inteken nou ‘n ekstra R5000 sal moet opdok of na ‘n goedgekeurde kliniek moet gaan.

Die reëling sal van 1 Februarie 2019 geld en doktors is glad nie gelukkig met die aankondiging nie.

Kenners wys daarop dat die mediese skema klaarblyklik meer ingestel is op winsbejag as op dienslewering aan pasiënte.

Sulke nuwe maatreëls word deur baie lede van die skema as onaanvaarbaar gevind, maar dit wil lyk of die bestuur en besluitnemers van Discovery doof geword het vir besware in die verband.

Deur: Die Vryburger
Hierdie berig weerspieël nie noodwendig die mening van SAUK-nuus nie.

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Free Medical-Aid, Hospital and Funeral Plan and Insurance Quotes at www.MedSure.co.za
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Oues se skokverhoging op Discovery-opsie

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Duisende pensioenarisse wat op die Discovery Health Medical Scheme (DHMS) se Keycare Plus-opsie is, moes tot hul skok hoor hul premies styg volgende jaar met sowat 47%.

Lede op die KeyCare Plus-opsie betaal premies gegrond op hul maandelikse inkomste.

Die skerp premieverhoging raak 139 000 lede wat op die laagste inkomstevlak van KeyCare Plus is. Van hulle is 19 000 ouer as 65.

’n Leser van Netwerk24 het gekla omdat haar 77-jarige ma, wat ’n maandelikse inkomste van R8 000 het, meer sal moet opdok. “Sy het vanjaar R990 per maand betaal en die premie styg volgende jaar tot R1 456, en die voordele bly dieselfde.”

Haar ma wou anoniem bly omdat sy nie wil hê mense moet weet wat haar inkomste is nie.

“My ma sit aan die hoër inkomstekant van wat al die jare Keycare se kliëntebasis was. Wat van al die ander mense wat veel minder verdien?”

Volgens haar is talle voordele tussen 2017 en 2018 weggeneem.

“Sy het natuurlik ander uitgawes ook, s
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Suid-Afrikaners is woes kwaad oor die Discovery-groep se swart aandeelhouer planne en wil van fondse verander, hoe maklik is dit egter om jou mediese fonds te verander?

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Baie Suid-Afrikaners is so warm onder die kraag oor die Discovery-groep se planne om aan swart deposante ’n 10%-belang in sy nuwe bank te gee dat hulle dreig om Discovery se mediese fonds te verlaat.

Die sangers Bobby van Jaarsveld en Steve Hofmeyr is deel van dié groep ontevredenes.

Mense wat dit oorweeg, moet hulle deeglik vergewis van die vereistes van die Wet op Mediese Skemas sodat hulle nie sonder dekking in ’n krisis gelaat word nie.

Eerstens geld ’n wagtydperk vir enige nuwe lid van ’n mediese fonds. Hoe lank dié wagtydperk is, hang af van hoe lank jy lid van jou vorige fonds was – langer of korter as twee jaar ononderbroke.

As jy langer as twee jaar lid was, geld ’n wagtydperk van drie maande, maar net as daar nie meer as 90 dae verloop tussen die lidmaatskap van die twee fondse nie.

In die drie-maande-wagtydperk moet jy die volle premie betaal, maar net eise ten opsigte van voorgeskrewe minimum voordele (VMW) en lewensbedreigende
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White South Africans very unhappy, and rightfully so, and now they are throwing their toys over Discovery Bank’s ‘racism’

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Discovery CEO Adrian Gore announced that we’re getting a new bank in 2019. Not only will Discovery Bank be the world’s first and only behavioural bank, but it will also be branchless and give Black clients 10% equity. Gore explained:
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And the money just keep rolling in:- R20 million payday for Discovery CEO Adrian Gore

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Insurance and finance group Discovery has published its integrated annual report for 2018, revealing what its top executives got paid for the year.

Group CEO, Adrian Gore, was rewarded with a total package of R19.8 million, including a R6.6 million basic salary, a bonus of R7.8 million, long-term incentives of R4.1 million and other benefits of R1 million and R313,000.

Gore’s incentives were largely based on the handling of Discovery Bank, which is set to launch as South Africa’s next big full service bank in the coming months. He also saw that the group hit its growth targets and ran a profitable business, Discovery said.

Group financial director, Deon Viljoen earned a R10.2 million total package, while CEO of Discovery Life Hylton Kallner was the highest-paid exec with a total package of R29.2 million.

Kallner’s huge payday was due to a R17.6 million LTI payout, which was as a result of the vesting of a three-year LTI scheme.

CEO of Discovery Hea
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Bonitas:- Price hike and big changes for medical aid plans in 2019

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Medical aid scheme Bonitas is to increase prices across its various plans by a weighted average of 8.9% in 2019 – while also launching two new lower-cost plans.

The group said that the weighted average is on par with the industry corridor of 3% to 4% above CPI, and comes amid a tough economic climate, which included a hike in VAT to 15% in April 2018.

“The past 12 months have been extremely trying, with a number of uncertainties and changes anticipated,” said Bonitas principal officer, Gerhard Van Emmenis.

Looking for a affordable Medical Aid or Hospital Plan, just click here Medical Aid or just send your Name, surname, age, area in which you live and email address to 082 738 5586

“In addition, consumers have been heavily impacted by the increase in VAT and escalating prices which resulted from this.”

In July Bonitas reporte
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The biggest medical aid schemes in South Africa – and how much they’re charging in 2018

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The majority of South Africa’s biggest medical aid schemes have released their prices for 2018, showing below 10% increases across all plans.

According to the latest statistics released by the Council for Medical Schemes (CMS), there are currently 82 medical aid schemes operating in South Africa with a total subscription of just under 8.9 million members as at December 2016.

Discovery remains the largest medical aid scheme in the country, with over 2.7 million members.

This is followed by the Government Employees Medical Scheme (GEMS) with 1.8 million members, and the Bonitas Medical Fund, with just under 680,000 members.

Due to the nature of medical aids, and how each scheme is structured to cater for different hospital networks and cover different medical needs, it’s incredibly difficult to compare like for like, especially on price.

However, with all medical aids now releasing their contribution structures for 2018, the tables below outline the pr
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Market concentration is plaguing South Africa’s private healthcare market

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The preliminary findings of a recent inquiry into South Africa’s private healthcare sector shows worrying trends. Key among the inquiry’s revelations are high concentration levels in the market.

For example, the report shows that 70% of the open medical schemes market is controlled by two players – Discovery Health Medical Scheme and Bonitas. The market for restricted medical aid schemes is dominated by the Government Employees Medical Scheme, with a 47% market share. The medical scheme administrators market is controlled by three players, Discovery Health, MMI Holdings and Medscheme. These three have a 70% combined market share.

The situation is no better in the market for private hospitals. Three hospital groups – Netcare, Mediclinic and Life Healthcare – hold 83% of the national market.

The concentration problem in the private healthcare sector is further compounded by integration. Two of the largest medical scheme administrators, Discovery Health and
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New Survey: Medical aid members have more choice

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In the battle for a slice of the private healthcare market, there has been significant growth in the number of medical schemes performing well across all sections of the medical aid spectrum. Whilst this means that members get more choice, it also makes the landscape increasingly complex.

The GTC 2018 Medical Aid Survey (MAS) analyses and rates medical aid schemes according to a standardised comparison and ranks the choices available to members.

When analysed purely in terms of premiums – the survey’s micro ranking – Fedhealth emerged as the medical aid which held the most top positions across all the classifications. Discovery was ranked in first place for the survey’s macro rankings, which analyses a medical aid’s overall ‘health’ and longevity in terms of factors such as its solvency level, membership growth, net healthcare result and member satisfaction. When combining both the GTC micro and macro rankings, Discovery claimed the highest number o
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Hier is die 20 beste hospitale in SA

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Die resultate van die nuutste peiling onder pasiënte wat Discovery Health uitgevoer het om die beste hospitale in die land aan te wys, toon sewe hospitale wat al vier jaar agtereenvolgens op die lysie is.

Lede van mediese skemas wat deur Discovery Health geadministreer word, het aan die peiling deelgeneem oor die hospitale waar hulle in 2017 opgeneem is. Die lys is uit 140 hospitale saamgestel.

Life Healthcare, en die onafhanklike netwerk van hospitale wat lede van die National Hospital Network (NHN) is, het die meeste hospitale op die lys.

Netcare het net een hospitaal op die lys.

NHN het die meeste hospitale wat reeds vier jaar agtereenvolgens op die lys is.

Hier is die lys van die 20 beste hospitale in alfabetiese volgorde:

1. Ahmed Al-Kadi- private hospitaal (Durban, KwaZulu-Natal)

2. eThekwini-hospitaal en -hartsentrum (Durban, KwaZulu-Natal)

3. Gateway- private hospitaal (Umhlanga Rocks, KwaZulu-Natal)

4. Hillcrest- private hospitaal (
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You are paying more for less when it comes to medical aid, does it make sense. Here’s why.

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What are your chances of ending up in a hospital? Higher than you’d think if you are a medical aid member in a large city — and the reason reveals some never-before-seen truths about the country’s private healthcare sector.

A lack of competition within the private healthcare market is fuelling an epidemic of overtreatment — and mystery medical bills — in South Africa, the Competition Commission revealed on Thursday.

As part of a four-year investigation into private healthcare costs, the Competition Commission looked at hospital admission rates among patients treated in nine specialised areas of medicine. People who had insurance and lived near more hospitals were more likely to be admitted than people with similar conditions that lived farther away from lots of empty beds, the statutory body found.

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Hospital Plan with no medical tests required or Funeral Plan from R99. Get Free Quotes for Medical-Aid, Hospital or Funeral Plans or Insurance now!

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Medical-aid

Get a Hospital Plan with Guaranteed acceptance and no medical tests or a Funeral Plan from only R99 per month. Get Free Quotes anytime for Medical-Aid, Hospital or Funeral Plans or any Insurance online now.

Simply email the word “Medical” or “Hospital” or “Funeral” or “Insurance” and your Full Name, age and Cell No. to: [email protected]
Or, SMS/WhatsAPP “Medical” or “Hospital” or “Funeral” or “Insurance” and your Full Name and email address to: 0827385586
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Union tells government to ‘fix the mess’ at KZN’s health department or else …

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Pietermaritzburg – The National Education Health and Allied Workers’ Union (Nehawu) has warned of an all-out strike if the KwaZulu-Natal provincial government does not “step up in fixing the mess” at the provincial health department. The warning was issued by Nehawu provincial secretary Phakama Ndunakazi on Thursday at the conclusion of a march in Pietermaritzburg…
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