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Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2019

Doctors

Requirements for switching medical invoices with the Compensation Fund

 

The switching provider must comply with the following requirements:

 

1. Registration requirements as an employer with the Compensation Fund.

 

2. Host a secure FTP server to ensure encrypted connectivity with the Fund.

 

3. Submit and complete a successful test file before switching the invoices.

 

4. Validate medical service providers' registration with the Health Professional Council of South Africa.

 

5. Validate medical service providers' registration with the Board of Healthcare Funders of South Africa.

 

5. Ensure elimination of duplicate medical invoices before switching to the Fund.

 

6. Invoices submitted to the Compensation fund must have Gazetted COIDA Tariffs that are published annually and comply with minimum requirements for submission of medical invoices and billing requirements.

 

7. File must be switched in a gazetted documented file format published annually with COIDA tariffs.

 

8. Single batch submitted must have a maximum of 100 medical invoices.

 

9. File name must include a sequential batch number in the file naming convention.

 

10. File names to include sequential number to determine order of processing.

 

11. Medical Service Providers will be subjected to Compensation Fund vetting processes.

 

12. Provide any information requested by the Fund.

 

13. The switching provider must sign a service level agreement with the Fund.

 

14. Third parties must submit power of attorney.

 

Failure to comply with the above requirements will result in deregistration of the switching house.