Covid-19 and Telehealth
To further reduce the person to person risk of transmission and reduce the number of patients at doctors’ rooms, the CMS (council of Medical Schemes) recommends that telehealth delivered through online platforms be reimbursed as PMB level of care in line with the latest Health Professions Council of South Africa (HPCSA) communication as published on their website.
In accordance with the HPCSA recommendations, “Telehealth should preferably be practiced in circumstances where there is an already established practitioner-patient relationship. Where such a relationship does not exist, practitioners may still consult using Telehealth provided such consultations are done in the best clinical interest of patients.”
In addition, HPCSA, emphasise that “Although practitioners may charge fees for consultations undertaken through Telehealth platforms, the Council [HPCSA] strongly cautions against practices that may amount to over-servicing, perverse incentives and supersession.”
In the out of hospital setting, no prior authorisation is required for telehealth consultations with a general practitioner, specialist consultations may require pre-authorisation.
Schemes can develop screening pre-risk assessment tools and use designated service providers (DSPs).
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Source: This information is sourced directly from Council of Medical Schemes website, and their document titled PMB definition guideline: COVID-19 v5 and does not rely on our own independent research
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