Support: 021 816 1930
Email: support@madetomeasure.co.za
Knowledgebase: Click here
 
 
Welcome to 2024!

Please read below for full details on how to get your 2024 tariffs loaded.  Bear in mind, though, that now might be a good time to consider upgrading to Panacea.  Why?  Here are a few reasons:
  • Panacea tariffs are fully automated.  You do not need to load anything manually and the whole process involves only a few clicks to select your options from Panacea's Tariff Wizard.
  • Panacea can maintain an unlimited number of pricelists, i.e. we generate one pricelist for each medical aid.
  • We also provide other pricelists, e.g. GEMS contracted, Discovery Network etc.
  • Most Panacea pricelists are generated from actual price files supplied by the medical aids, i.e. they are 100% accurate.
  • Panacea can automatically match each pricelist with the equivalent medical aid.
  • Panacea can implement a variety of billing scenarios, e.g. scheme-matching pricing and balance billing
For full details on Panacea, please visit our website by clicking here .
 

How to import / update your medical aid tariffs for 2024:


1. 2024 rates.
These rates are supplied free of charge as a courtesy to our users.   If you do not understand how the billing works please read this https://madetomeasure.freshdesk.com/solution/articles/17000069875-how-the-billing-works-.
The basic procedure is to import the Discovery rates (4 below)  and then import the Medical Aid %'s(5 below)

2. This Update includes:

i. Discovery rates (DHR) for most of the allied disciplines (see 4 below) for funds that use the DHR.

ii. Medaid %'s for the funds that use the 2010 base rate to calculate the price for each code.  NOTE: This will not be 100% accurate to what the fund pays. It is an approximate value.  Also, some medical aids increase their tariffs by different percentages for different disciplines so the prices may actually be way off.  To improve accuracy see 6 below.  If you want your tariffs to be accurate to the cent then we suggest you upgrade to Panacea.

iii. Private and IOD rates are not provided - please maintain them yourself.

3. Backup and update the program:

Take a backup. If you are not on the latest version it is advisable to update. Professional users apply Profupdate from the Knowledge Base.  Synergy users go to Housekeeping -> Upgrade in the program.

4. Get the new Discovery rates (DHR):

i. Disciplines 91 Biokinetics, 04 Chiropractics, 08 Homeopathy, 66 OT, 72 Physio, 86 Psychology, 82 Speech Therapy / Audiology, 81 counselling, 84 dietetics, 83 Hearing aid Acoustician, 88 Nurses, 89 Social Work, 13 Oral Hygeine, 68 Podiatry, 85 Psychometry, 22 Psychiatry, 39 Radiology,
On the tariff code screen go to 'Import' then 'WebUpdate' then again 'Import'.

ii. All other disciplines -
On the tariff code screen use the 'Increase' button to increase the Discovery column by 5.2% for the 2024 increase.
NB Before billing check each code price to those from the Discovery website - if you charge too much by 5c they will pay the patient instead of you.

iii/ If you have a special contract with Discovery you will need to enter the special rates that replace the DHR.

iv/ Doctors and specialists can calculate more accurate rates using units and RCF see 7 below.

5. Update the medaid %'s.

On the Medical Aid screen, go to 'Import', then 'WebUpdate' , then again 'Import'.  

On Professional any funds that have been set to use their own column will revert to the Medaid 2010 column after this update and you will need to reset them to use their special column again.   This will not happen in Synergy where only those funds that use the MedAid2010 column will have their %'s changed.

Note that if you have set patients to use a different rate to the medical aid standard, then they will revert to standard when you do this update.

6. Improve accuracy on funds using % based billing.

i/ Tweak the % to suit your practice / discipline -

Do this easy calculation for a few of your codes to get a range of %'s
Medaid 2010 price is the price for the code on tariff code screen in column2
Actual price is the published actual rate that the medical aid says they will pay for that code.

(Actual price - Medaid 2010 price ) / Medaid 2010 price x 100 = % above the 2010 rate that this medical aid will pay for this code
Add 100 to this % before entering it in on the Medical Aid screen in the Billing %
It is best to use the lowest of the range of %'s you get so that all your invoices are = or slightly less than the published price. This way you will avoid irritating small amounts that have to be written off.

ii/ For 100% accuracy you will need to create a column of rates especially for the fund. Use the 'columns' button on the tariff codes screen and type in the actual rate per code. Then go to the Medical Aid screen and change the billing on the fund to use the new column at 100%.
Funds that it may be helpful to do this for are GEMS, NMS, Bestmed, Bankmed.
Physios will need to set up a special column for Bestmed as they have added new codes and also changed the weightings on existing codes which makes them impossible to calculate from the 2010 base rate.
Note that Professional users are limited to 5 extra columns while Synergy users have no limit on columns.

iii/ Exception codes can be created for specific codes when the % increase does not work - especially for Doctor's consultations.
(See Helpfiles - 'exception' )

7. Doctors - Improve accuracy by calculating from units and RCF

RCF values are available for most funds / plans.

2024 DHR RCF are:
CPU (clinical procedure units type 20) = 17.034
Spec anaesthetist (AU type 30 ) = 128.648

To use this option see HelpFiles  'Tariff codes Units'

8. Help with updates.
The procedure is explained here  https://madetomeasure.freshdesk.com/solution/articles/17000075574-how-to-update-your-medical-aid-rates-from-within-the-program and in the helpfiles.
 
Datamax  support can help you telephonically with these updates on 021 816 1930.  Note that Datamax charges for support, as did the previous owner.  Note that if you have problems with anti Virus software blocking the downloads you may require the services of a technician.   For most disciplines it is also easy to update the rates manually - see https://madetomeasure.freshdesk.com/solution/articles/17000075575-how-to-update-your-medical-aid-rates-manually

8. Disclaimer.
While we try our best to give you the most accurate information possible, we cannot be liable for any errors / discrepancies. Please check your rates and adjust as needed.

9. Medical Aid %'s 
These %'s represent the accumulated increases by each fund over the past 14 years and are used, in conjunction with the MedAid2010 rate, to calculate each treatment line's value.  Note that where the percentage increase is not known we have used the average 5.2%.

Code Name Administrator Base Tariff 2024 % 2024 on base Notes ROUND
027 AECI (Healthcare) Medscheme MedAid20105.00210.49
10c
276 Affinity Pan-African Managed CarMedAid2010204.67
10c
224 Alliance Midmed Private Health Admin MedAid20105.00208.20
10c
037 Anglo Medical Scheme Discovery Health DHR5.20100.00
10c
390 Anglogold Ashanti Providence MedAid2010203.60
10c
036 Anglovaal Discovery Health DHR5.20100.00
10c
042 Bankmed Discovery MedAid20105.20210.09
10c
043 Barloworld / Barlows Medscheme MedAid20106.50202.19
10c
045 Bestmed Bestmed MedAid20104.50206.74
10c
048 BMW Employees Discovery Health DHR5.20100.00
10c
050 Bonitas Medscheme MedAid20106.50206.94
10c
056 BP Southern Africa MHG MedAid20106.00216.39
10c
733 Building & Construc Ind Status Medical Admin MedAid20105.00211.81
10c
079 CAMAF Sanlam Health Care MedAid2010211.75
10c
052 Cape Medical Plan Cape Medical Plan MedAid2010230.64
10c
561 Carecross Carecross MedAid2010203.60
10c
389 Centre for Diabetes Sanlam Health Care MedAid2010203.60
10c
129 Compcare Status Medical Admin MedAid20105.00209.57
10c
704 Compsol Compsol 100.00
10c
066 De Beers De Beers MedAid20105.45214.28
R1
125 Discovery Discovery Health DHR5.20100.00
10c
269 Engen Discovery Health DHR5.20100.00
10c
516 Essentialmed Pan-African Managed CareMedAid20105.50204.97
10c
160 Fedhealth Medscheme MedAid20106.50207.13
10c
779 Fishing Industry MMI MedAid20105.20209.48
10c
083 Foschini Discovery Health DHR5.20100.00
10c
470 Furnmed Eminent Wealth MedAid2010203.60
10c
875 GEMS MHG MedAid20105.20208.12
10c
518 Genesis Difiniti MedAid2010211.42
10c
349 Getmed Getmed MedAid2010203.60
10c
504 Getsavvi Pan-African Managed CareMedAid20105.50204.97
10c
181 Glencore (Xstrata) Discovery Health DHR100.00
10c
363 Golden Arrow MMI MedAid20105.20213.07
10c
259 Grintek GEMAS Status Medical Admin MedAid2010208.40
10c
597 Hairdressing Trade Hairdressing Trade MedAid2010203.60
10c
870 Harmony Health Services Providence MedAid2010206.31
10c
472 Health 4 Me MMSA MedAid20105.20201.95
10c
421 Health Squared Agility GHS MedAid2010203.23
10c
444 Horizon Medical Scheme Medscheme MedAid20105.60216.79
10c
523 Hosmed Allcare MedAid2010211.80
10c
439 Impala Providence MedAid20105.20206.56
10c
364 Imperial Group MHG MedAid2010213.15
10c
221 Impilo Care Universal Healthcare MedAid2010203.60
10c
454 IOD - WCA IOD - WCA 100.00
510 Keyhealth PMSA MedAid20105.00218.63
10c
525 LA Health (LAMAF) Discovery Health DHR5.20100.00
10c
099 Libcare VMed MedAid2010216.40
10c
008 Liberty Health Blue VMed MedAid2010211.43
10c
945 Lonmin Discovery Health DHR5.20100.00
10c
302 Makoti Enablemed MedAid2010205.69
10c
104 Malcor Discovery Health DHR5.20100.00
10c
038 Massmart Universal Health MedAid20105.93221.56
10c
180 MBMed /CDA Medscheme MedAid20106.50209.10
10c
418 Medicall Private Health Care MedAid2010203.60
10c
256 Medihelp Medihelp MedAid20105.00214.25
10c
265 Medimed Providence MedAid20105.00206.18
10c
250 Medipos MHG MedAid2010216.20
10c
111 Medshield Medshield MedAid2010212.14
10c
362 MMED Discovery Health DHR5.20100.00
10c
822 Momentum Health MMSA MedAid20105.20198.01
10c
940 Moto Health Care MMSA MedAid20105.20207.11
10c
206 Namibia Health Plan Medscheme Namibia MedAid2010201.48
10c
512 Naspers Discovery DHR5.20100.00
10c
214 National Health Care National Health Care MedAid2010203.60
10c
010 NBCRFLI Universal Health MedAid2010203.60
10c
016 Nedgroup Medscheme MedAid2010209.00
10c
067 Netcare Discovery MedAid20105.20209.70
10c
624 Nufawsa Sick Benefit Eminent Wealth MedAid2010203.60
10c
987 OcsaCare Carecross MedAid2010203.60
10c
701 Old Mutual Health Plan Universal Healthcare MedAid2010203.60
10c
012 Old Mutual Staff Medscheme MedAid20105.00208.76
10c
468 OnePlan Oneplan Underwriting ManMedAid2010203.60
10c
142 Opmed Opmed MedAid2010203.60
10c
143 Parmed Medscheme MedAid20106.50207.13
10c
146 PG Group MMI MedAid20105.20208.37
10c
376 Pick 'n Pay MMI MedAid20105.20213.19
10c
266 Platinum Health Platinum Health MedAid20106.00203.87
10c
219 Polmed Medscheme MedAid20105.30210.79
10c
642 Primecure Assorted Primecure MedAid2010203.60
10c
154 Profmed PPS MedAid20105.40207.40
10c
162 Quantum Discovery Health DHR5.20100.00
10c
818 Rand Mutual Assurance Rand Mutual Assurance 100.00
10c
607 Rand Water Sanlam Health Care MedAid2010210.44
10c
161 Remedi Discovery Health DHR5.20100.00
10c
061 Resolution Health Agility GHS MedAid2010206.51
10c
608 Retail Meat Trade Retail Meat Trade MedAid2010203.60
10c
946 Retail Medical Aid SchemDiscovery Health DHR5.20100.00
10c
645 RFMCF PPSHA MedAid20103.00199.35
10c
780 Roshmed Roshmed MedAid2010203.60
10c
581 RU Med/ TEMS Providence MedAid20105.00205.20
10c
179 SAB (SA Breweries) Discovery DHR100.00
10c
176 SABC / SAUK Medscheme MedAid20106.50209.93
10c
611 SAMWUMed SAMWUMed MedAid20105.00218.24
10c
175 Sasolmed Medscheme MedAid2010204.53
10c
022 Sedmed Sedmed MedAid2010203.60
10c
004 Selfmed SelfMed MedAid2010221.35
10c
188 Sibanye Gold Providence MedAid2010206.27
10c
116 Sisonke Health Providence MedAid20105.00205.20
10c
178 Sizwe Sechaba MedAid20105.00212.85
10c
522 Spectramed Agility Global Health MedAid2010208.46
10c
614 Spes Bona Spes Bona MedAid2010203.60
10c
072 Suremed Providence MedAid20105.00205.20
10c
240 Swazimed Swazimed MedAid20104.70206.57
10c
769 Thebemed Providence MedAid20105.20212.66
10c
228 Tiger Brands Status Medical Admin MedAid20105.00214.83
10c
003 Topmed Private Health Admin MedAid2010214.85
10c
194 Transmed MHG MedAid20105.20208.94
10c
778 TruCare Universal Healthcare MedAid2010203.60
10c
944 Tsogo Sun Group Discovery Health DHR5.20100.00
10c
615 Ultracare Ultracare MedAid2010203.60
10c
920 Umvuzo Health Umvuzo MedAid20105.40209.90
10c
484 Unity Health Ambledown MedAid2010203.60
10c
431 Universal WorkerPlan Universal Healthcare MedAid2010209.83
10c
197 University of KZ-Natal Discovery Health DHR5.20100.00
10c
201 Witbank Coalfields Witbank Coalfields MedAid2010213.32
10c
198 WitsMed Discovery DHR100.00
10c
202 Wooltru MHG MedAid20105.20214.53
10c