PPD Portfolio
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| Sue Scharf has been serving on the Executive Committee for the past four years in the PPD Portfolio. She has been in Private Practice in Randburg for the last 13 years, and currently has a busy practice. Sue is also involved in coaching dietitians, providing skills that assist them in running and managing a dietetic private practice. Sue represents all the Private Practising Dietitians in ADSA, who have unique needs as prescribed by the HPCSA, the BHF and most importantly, the Council for Medical Schemes (CMS). The CMS bridges the gap between health care providers (including PPDs) and the health care funders, i.e. the registered medical schemes; supervising all aspects of how they (should) function. They have brought about some incredible re-structuring and changes over the last 4 years within the private medical sector, and these changes have directly affected the way in which PPDS run their businesses. |
Sue Scharf PPD Portfolio |
Sue Scharf on behalf of ADSA has been involved in liaising with the CMS regarding certain changes involving dietitians. Most important have been a) the development of the NHRPL (National Health Reference Price List) for dietitians, involving a time-billing structure as opposed to the previous "BHF rates" (billing per actual type of treatment / assessment done); and b) the implementation of ICD10 (diagnosis) codes, now a legal requirement on all claims submitted to medical schemes for reimbursement. The latest NHRPL can be obtained from the CMS website: www.medicalschemes.com. The ICD10 Short-List can be obtained from ADSA (this is currently under review by the ICD10 task team at the CMS).
These changes have influenced the way in which dietitians must generate invoices and statements, and dietitians have been encouraged to use software that has been specifically developed to include the changes. There are specific requirements for a statement layout, and dietitians are requested to comply with these requests in order that claims are more standardised, professional-looking, and to ensure that patients or providers are adequately and efficiently reimbursed for claims submitted.
The last four years have, therefore, been very interesting, challenging and exciting on the PPD front. In general, most PPDs feel that they are now being reimbursed more appropriately for services rendered, and are finally being recognised as an essential part of the Health Care Team. There are still some areas, specifically for hospital dietitians, which are being addressed, hopefully with some positive resolutions expected over the next few months.
PPDs have a very important role to play, and ADSA has also found it rewarding being able to assist PPDs with certain marketing tools, eg the "If it's about nutrition, ask your dietitian" pamphlets and magazine fillers.The PPD Manual has been upgraded and the 2006 version is available from ADSA at a cost of R65 including p & p.
These changes have influenced the way in which dietitians must generate invoices and statements, and dietitians have been encouraged to use software that has been specifically developed to include the changes. There are specific requirements for a statement layout, and dietitians are requested to comply with these requests in order that claims are more standardised, professional-looking, and to ensure that patients or providers are adequately and efficiently reimbursed for claims submitted.
The last four years have, therefore, been very interesting, challenging and exciting on the PPD front. In general, most PPDs feel that they are now being reimbursed more appropriately for services rendered, and are finally being recognised as an essential part of the Health Care Team. There are still some areas, specifically for hospital dietitians, which are being addressed, hopefully with some positive resolutions expected over the next few months.
PPDs have a very important role to play, and ADSA has also found it rewarding being able to assist PPDs with certain marketing tools, eg the "If it's about nutrition, ask your dietitian" pamphlets and magazine fillers.The PPD Manual has been upgraded and the 2006 version is available from ADSA at a cost of R65 including p & p.