Item Code

Description

COIDA 2021 Tariffs

1012

Consultation

387.21

1100

Air conduction, pure tone Audiogram

408.90

1110

Full speech audiogram including speech reception

205.67

1830

Hearing Aids

334.13

SPEECH THERAPY

1020

Consultation

334.13

1051

Therapy treatment up to 30 minutes

263.26

1053

Therapy treatment up to 1 hour

438.77

RULES GOVERNING AUDIOLOGIST

001

Pre-Authorisation is required for all hearing aids.

Code 1830:

002

Maximum amount payable is R9 581.95 (VAT inclusive).

The amount includes global charge for supply and fitting of hearing aids.

Motivation from the treating medical practitioner will be required for renewal of hearing aids.

003

An audiologist must have a referral letter from an ENT, a quotation and have two diagnostic audiograms when applying for hearing aids for an employee.

004

Renewal of hearing aids will be considered only after 5 years with two diagnostic audiograms and a motivation for renewal.

Speech Therapy Rules

006

Hospitalised patients will be allowed up 10 sessions without pre-authorisation. After a series of 10 treatment sessions in hospital, the treating practitioner must submit motivation with a treatment plan to the Compensation Fund for authorisation.

007

The service of a speech therapist shall be available only on written referral by a medical relationship to the original injury. The referral may be on the service providers (Speech Therapy practice) letterhead, provided it is signed by the referring doctor.

008

The Speech Therapist must submit the supporting referral with motivation from the medical practitioner together with the detailed speech therapy rehabilitation report and treatment plan following the first consultation to enable the fund to authorise the treatment sessions, as clinically appropriate and supported by the rehabilitation plan, once pre-authorisation by the Compensation Fund has been provided. The Speech therapist must submit monthly progress which reflect the nature of the rehabilitation progression against the rehabilitation plan (Annexure B). Speech Therapists must reflect the final change in the outcome measures in the final rehabilitation report (Annexure C)

009

Should additional treatment sessions over and above the initial authorised treatment sessions over and above the initial authorised treatment sessions be required, the Speech Therapist must provide an updated rehabilitation report (Annexure A), including outcome based measures and rehabilitation plan, with referral from the medical practitioner clearly stating the requirement for further treatment sessions. Such treatment must be authorised by the Compensation Fund prior to the treatment being provided.

110

Out-patients: All treatment sessions will need pre-authorisation. All request for pre- authorisation must be based on clinical need, best practice and be in the best interest of the patient. The speech therapy must submit a referral with motivation from the treating doctor and a treatment plan. The first consultation can be done before pre- authorisation to allow the speech therapist to provide a treatment plan to the fund for preauthorisation. Practitioners will be allowed up to five (5) treatment sessions to continue with treatment after submitting their request while awaiting response from the Fund. The rehabilitation professional must submit monthly progress report.