Question NW1498 to the Minister of Health

Reply:

1. The Uniform Patient Fee Schedule (UPFS) is Ministerial approved annually, based on the MTBS (CPI).

2. A UPFS Technical Tariff Task team has been established and consist of both provincial and national representatives of which national facilitates the process and provide guidance;

3. The UPFS makes provision for three groups of users: Full paying, subsidized and free users:

• Full Paying

This category of users includes but is not limited to externally funded users, users being treated by their private practitioner and certain categories. They are liable for the full UPFS fee.

• Subsidised

Subsidised users are categorised based on their ability to pay for health services into four categories: H0, H1, H2 and H3. The fees payable by subsidised users are expressed as a percentage of the fees payable by full paying users as determined by the latest edition of the Uniform Patient Fee Schedule (UPFS).

• Free

There are certain circumstances under which users will receive services free of charge independently of their classification as full paying or subsidised users. These circumstances have a statutory basis and apply only to the episode of care directly related to the circumstances under which the user has qualified for free services.

4. The UPFS further makes provision for non subsidised services and the full UPFS tariff applies irrespective of the classification of the patient.

• Cosmetic Surgery (None Medical Reasons)
• Medical Reports
• Mortuary services
• Autopsies
• Port Health and Travel Medicine

MEDICAL REPORTS (Examinations)

This tariff is levied for the completion of a report for insurance or any other purpose e.g. medico-legal and / or procedure above that required for the purposes of the report are undertaken. If a clinical examination and/or procedure are undertaken in addition to the examination, the relevant categories of that particular tariff should also be charged.

The tariff fee is payable strictly in advance before any information is disclosed. This tariff grouping accommodates: the issue and/or the completion of original medical reports and the completion of certificates/forms; as well as the issue of copies of reports/records.

Current UPFS

The tariff payable by e.g. Medical Scheme, Insurance Company etc. is R620.00 for

the financial year 2019/2020

CODE	DESCRIPTION	BASIS	Professional Fee	FACILITY FEE
				LEVEL 1	LEVEL 2	LEVEL 3
			R	R	R	R

04	Medical Reports - 100%
0410	Medical Report – Facility Fee	Report		185	185	185
0411	Medical Report – General medical practitioner	Report	435
0412	Medical Report – Specialist medical practitioner	Report	435

Response from the Mpumalanga Health Department after consultation with Rob Ferreira Hospital on the process followed for Medical Reports and stamps:

The patient will request the completion of the medical report in writing or verbal. The Patient Accounts or Patient Admission will request payment upfront before the completion of the form, immediately payment is received, the form will be forwarded to the specific doctor for completion and the relevant section will stamp it after either Patient Admission or Accounts. The charging of the completion of the form is as per the UPFS tariffs regardless of the level of the hospital.

If is difficult to reply to the question as more information is needed on the patient and exactly what form is referred too to give a more defined answer

END.