South African Medical Schemes

Most medical schemes fund the Venefit™ procedure (Radio Frequency Ablations - RFA) in part or full, if performed by a surgeon in an office setting. We will assist you by submitting a request for authorization on your behalf. Some medical schemes like Discovery funds the procedure from your in-hospital or major risk benefit and not from your savings plan. We enjoy a very good relationship with Discovery Medical Scheme and Dr Blignaut is a preferred provider to Discovery Classic and Discovery Executive patients.

Other larger medical schemes that cover the procedure in part or full are Momentum, Fedhealth, Camaf, Bonitas, Profmed. Schemes that do not fund the RFA procedure include MSO Medshield and Keyhealth. Resolution Health and Keyhealth will pay an amount towards the procedure if requested by the patient in some instances. GEMS, Polmed and Medscheme patients are sometimes required to pay a larger co-payment. As of January 2018 Bestmed offers selective coverage in part and full, depending on plan type.

Please note this feedback from Medical Schemes : "Radio Frequency Alation of Varicose Veins (VNUS Procedure) Benefits will be paid for an endoluminal radiofrequency ablation procedure(incl. disposables and duplex doppler) when performed in the rooms by a vascular or general surgeon.No benefits for procedure if done in hospital."

The shortfall amount, as estimated, based on your medical aid and option is payable on the day of your procedure. This amount ranges from R0 - R8000 in most instances. Where no authorisation is obtained prior to the procedure, you will be required to pay in full on the day of the procedure.
A written quotation is always available on request prior to your procedure. Where possible, we will obtain a pre-authorisation from your medical aid on your behalf for your procedure.

International patients

The Venefit™ procedure is covered in some instances by international medical schemes. This coverage is case dependant. We will provide you with a written quotation or estimate prior to your procedure. The full amount of your treatment is payable on the day of your procedure. We accept cash, credit cards(Visa or Mastercard) or bank transfers as payment. You will be given a detailed statement with itemized billing for submission to your medical insurer for refund.

Cosmetic vein treatments

Cosmetic vein treatments include mostly sclerotherapy for small spider veins. The improvement is cosmetic only and is not covered by medical schemes. You will not be able to claim this amount from your medical aid. Sclerotherapay is billed per session and these sessions range from 15 to 30 minutes each. Cosmetic Sclerotherapy pricing starts at R1300 per session, this excludes the cost of your required compression stockings of R550.

Foam sclerotherapy is a different entity and is sometimes medically indicated. This is unfortunately poorly covered by Medical schems. Foam sclerotherapy is administered by Dr Blignaut and starts at R2400 per session. Payment is required on the day of the procedure.

Medical aid codes for procedures

We are often asked to provide billing codes to prospective patients without being able to see the patient. We provide a number of different vein treatments and it is not possible to know which treatment you will require without first examining you and obtaining a proper medical history.

You are welcome to contact us to enquire about coverage on your particular medical scheme. Please provide us with your medical scheme and option, and we will give you an estimate based on previous billing history of your expected coverage.

Once you have been for a consultation, we will be able to provide you an exact estimate and written quotation with all the relevant codes and amounts.

Payment Options

Once your procedure has been pre-autorized by your medical aid, you will only be required to pay the shortfall on the day of your procedure. The balance of your account will be submitted to your medical scheme for payment. Once we receive payment from your medical scheme, your account will be reconcilled. Any shortfall will remain your responsibility to pay, and any over payment will be refunded to you. We accept cash, credit cards(Master Card and Visa), and electronic fund transfers(EFT). Once your personal details have been captured on our system and you are registered as a patient in the practice, we will provide you with our banking details for EFT.

Please keep in mind that you have had the freedom in choosing your medical scheme. You have a contract with your medical scheme. We as a medical practice is not party to this agreement. We provide a service and render an account for payment to you, our patient. You are responsible for payment of this account in full. We will always provide you with transparent pricing to avoid any surprises.

Procedure Financing

In some instances medical procedure finance is needed. You may see www.fhf.co.za These financial institutions might be able to assist in obtaining a health care loan. We do not endorse these companies or suggest you use them and have no financial interest in them, but merely provide their details for your consideration.

Gap Cover

Gap cover medical insurance remains an unregulated entity in medical funding. We do not have any control over the way that these companies pay for your claims. We do not accept payment from gap cover insurance. You will be required to pay for the shortfall or gap, and then reclaim from your gap insurance. Feedback from patients is that Sanlam Gap Cover pays for the shortfall.

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