Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2021Renal Care Gazette 2021Requirements 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. |
| 15. | Only Pharmacies should claim from the Nappi codes file. |
Failure to comply with the above requirements will result in deregistration of the switching house.