Injury on Duty Fees (WCA)
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WCA adjusted Rand conversion factor (RCF) of R12.29 effective from 1st April 2006;
all claims for services delivered from April 1 will be paid out according
to the new tariff. This represents a paltry 4% increase.
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There are numerous instances of items under the SAMA guide to billing that have
not been accepted or implemented by WCA e.g. reversal Hartmann, consultation
codes, or old unit values (e.g. colostomy closure). Members are advised to use
the SAMA billing guide for information.
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Their poor payment track record has been repeatedly addressed, without
satisfactory outcomes. The office of the Compensation Commission (CC) is
apparently working on a simplified and less cumbersome claims process for
doctors. The proposed system makes provision for claims to be submitted at
local/provincial labour centres. According to the CC claims could be paid out
within 10 days. A pilot project for the new system is envisaged to start later
this year.
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Meanwhile doctors are still enquiring about the legal options available to
individual doctors for claiming back outstanding COIDA fees, some of which date
back to 1998!!!
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The South African Medical Association has negotiated a reasonable contingency
fee for its members who choose to follow the legal route. More information is
available on the SAMA website at: http://www.samedical.org/coid.asp or phone
Kevin Duke on 082 3774323 or Ian King on 082 882 5807
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SpesCompensate is a service product developed by an alliance between SpesNet
and Corporate Liability Services (Pty) Ltd to assist SpesNet Specialist members
with the recovery of injury on duty fees (10% commission, “no recovery, no fee”
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