n South African Medical Journal - When will we escape from the medical funding industry's 'spin'? : correspondence




I am a specialist in private practice. A patient recently asked for a quotation for an operation, and I supplied her with the relevant codes and pricing structures. As we have no contracts with medical aids she was advised to contact her insurer to ascertain which payments she could expect. Obtaining this information from them was a challenge. She was informed that they could not provide an estimate as to which part of the cost they would cover (thankfully, she was not regaled with the usual 'we refund 100%, 200% and even 300% of the bill'). She was also told that they had not heard of code 0023, which is the anaesthetic modifier for time that must feature on an anaesthetic account and with which most funders are familiar.


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