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Circulars

MediKredit Circulars: Pharmacies
Reference Number Effective Date Subject
020/2020 Immediate Pick N Pay Next File Date Functionality
019/2020 Immediate Various Schemes Early Refill/Next Fill Date
018/2020 Immediate CIGNA Pan-African Parliament Scheme Termination
017/2020 01/08/22020 PPSHA KeyHealth New Virtual Consultation Tariff
016/2020 Immediate WCMAS Next Fill Date
015/2020 Immediate SABMAS Next Fill Date
014/2020 Immediate Bankmed Next Fill Date
013/2020 Immediate Anglo AMS Next Fill Date
012/2020 01/08/2020 Building Industries (BIMAF) Pat Claims Processing /New RMR7997
011/2020 01/07/2020 Grintek Electronics Medical Scheme Termination
010/2020 Immediate Pick N Pay PAT Max Increase
009/2020 26/03/2020 General Information
008/2020 Immediate Platinum Flu Vaccine Claims
007/2020 Immediate CIGNA Pan-African Parliament New Scheme Information
006/2020 24/03/2020 Compensation Fund Scheme Termination
005/2020 01/03/2020 Massmart Emergency Services Insurance Claims
004/2020 Immediate PPSHA KeyHealth New Pharmacy Tariff
003/2020 Reminder RFMCF Regular Force Medical Continuation Fund Reminder of Claims Processing
002/2020 Immediate SABMAS MMAP on HIV Claims
001/2020 01/01/2020 Medibucks Tariff Changes
032/2019 01/01/2020 GEMS Year-end changes
031/2019 01/01/2020 Momentum Health Assessment NAPPI Price Increase
030/2019 01/01/2020 Bankmed Year-end Changes
029/2019 01/01/2020 KeyHealth Year-end Changes
028/2019 01/01/2020 Universal Compcare Confirmation of Plans/Benefit Options for Compcare in 2020
027/2019 01/01/2020 SABMAS Year-end Changes
026/2019 01/01/2020 WCMAS Year-end Changes
025/2019 01/01/2020 CAMAF Year-end Changes
024/2019 01/01/2020 Profmed year-end changes
023/2019 01/01/2020 PICK N PAY Year-end Changes
022/2019 01/01/2020 Mamoth New Elite Magenta Benefit Option
021/2019 01/01/2020 Platinum Health Year-end Changes
020/2019 01/01/2020 RFMCF Pharmacy Tariff Increase (year-end 2019)
019/2019 01/01/2020 Rand Water PAT/OTC Max Benefit Change (year-end 2019)
018/2019 Immediate CIGNA Jesuit Refugee Services (JRS) New Option
017/2019 Immediate Rand Water General Notification of Statement Error
016/2019 01/10/2019 Selfmed Medical Scheme Merger with Compcare Medical Scheme
015/2019 Immediate Bankmed New Risk Management Response (RMR) Code 7929
014/2019 01/09/2019 Universal Workerplan Rebokrant Claims Information
013/2019 Immediate MediBucks EDCON Option Termination
012/2019 01/07/2019 RFMCF Claims Related Enquiry Contact Details
011/2019 01/07/2019 Old Mutual Staff (OMSMAF) Administrator Change/Option Replacement
010/2019 Immediate CAMAF New Pharmacy Tariff
009/2019 Immediate RFMCF New Pharmacy Tariff Codes
008/2019 01/06/2019 Discovery Medical Scheme Diabetes Medicine Claims
007/2019 01/06/2019 Platinum Health New PlatFreedom Benefit Option
005/2019 01/04/2019 Old Mutual Health Plan (OMHP) Insurance Option Information
004/2019 01/04/2019 Watch Tower Claims Processing Information
003/2019 Immediate KeyHealth Reminder of Health Assessment NAPPI
002/2019 Immediate Cigna Nestle Scheme/Option Termination
001/2019 01/01/2019 Bankmed PAT Benefit for Core Saver Plan Members
038/2018 01/01/2019 Workerplan Trucare Plan Name Change
037/2018 01/01/2019 GEMS Year-end Rule Changes
036/2018 01/01/2019 GEMAS New Scheme Information (Grintek)
035/2018 01/01/2019 BCIMA New Scheme Information
034/2018 01/01/2019 Universal Transmed State Plus Network Plan Name Change
033/2018 01/01/2019 Centre for Diabetes & Endocrinology (CDE) New Scheme Information
032/2018 01/01/2019 Universal Umvuzo Year-end Changes
031/2018 01/01/2019 SABMAS Year end Changes
030/2018 01/01/2019 KeyHealth Year end Changes
029/2018 01/01/2019 Platinum Health PAT Max Change for 2019
028/2018 01/01/2019 Rand Water PBM Processing
027/2018 01/01/2019 WCMAS Year-end Changes
026/2018 01/01/2019 CAMAF year-end Changes
025/2018 01/01/2019 Bankmed Year-end Changes
024/2018 01/01/2019 Profmed Year-end Changes /New Plans
023/2018 01/01/2019 Momentum Health Assessment NAPPI Price Increase
022/2018 01/01/2019 PICK N PAY Year-end Changes
021/2018 01/01/2019 Anglo AMS Year-end Changes
020/2018 01/12/2018 Universal Tiger Brands Mzansi Benefit Option Name Change
019/2018 01/12/2018 (ON HOLD) MediBucks New EDCON Option Information
018/2018 24/09/2018 SABMAS Rejection of Old Membership Numbers
017/2018 08/02/2016 RFMCF Reminder Circular (Indicating NON-PPN Providers dispensing Fee)
016/2018 16/07/2018 CIGNA Administrator Option Name Change
015/2018 Immediate CAMAF New Risk Management (RMR) Response Code (7828)
014/2018 01/07/2018 Old Mutual Staff (OMSMAF) New Network & Network Select Option
013/2018 01/04/2018 Bankmed Pharmacy Tariff Change Due to VAT Increase
012/2018 01/04/2018 WCMAS Amendments Due to VAT Increase
011/2018 01/04/2018 PICK N PAY Amendments Due to VAT Increase
010/2018 01/04/2018 Profmed Amendments Due to VAT Increase INDEPENDENT & NON-PPN ONLY
009/2018 01/04/2018 Platinum Dispensing Fee Amendments Due to VAT Increase
008/2018 01/04/2018 Harmony Gold Mines Amendments Due to VAT Increase
007/2018 01/04/2018 KeyHealth Amendments Due to VAT Increase
006/2018 Immediate General - MediKredit Change of Postal Address
005/2018 01/04/2018 General - Amendment Due to VAT Increase from 14% to 15%
004/2018 Immediate CIGNA MTN Validation Change & FamCheck Functionality
003/2018 Immediate CIGNA International MTN New Scheme Information
002/2018 Immediate Cigna Schemes Dispensing Fee Change
001/2018 Immediate CIGNA Administrator – Reminder of Scheme information
034/2017 Immediate Anglo AMS New RMR 7799 & 7800
033/2017 01/01/2018 Universal Administered schemes Dispensing Fee Change
032/2017 01/01/2018 SABMAS Yearend rule changes
031/2017 01/01/2018 Momentum Heath Assessment NAPPI Price Increase
030/2017 01/01/2018 GEMS Year-end Rule Changes
029/2017 01/01/2018 MMI Pick N Pay Year-end Changes
028/2017 01/01/2018 Universal WorkerPlan Flu Vaccine Claims from Pharmacies
027/2017 01/01/2018 CAMAF Year-end Rule Changes
026/2017 01/01/2018 CareCross /ONECARE Option Terminations
025/2017 01/01/2018 Bankmed Year-end Rule Changes
024/2017 01/01/2018 WCMAS Year-end Rule changes
023/2017 01/01/2018 KeyHealth Year-end Changes
022/2017 01/01/2018 Profmed Year-end Changes
021/2017 15/12/2017 CareCross Scheme Termination
020/2017 Immediate SABMAS Confirmation of Option to be Used
019/2017 Immediate SABMAS MMAP Information
018/2017 Immediate CareCross OCSACARE Ackermans Termination
017/2017 immediate Discovery Bankmed New Risk Management (RMR) Code 7722
016/2017 Immediate RFMCF Stale Claim Period Change
015/2017 07/08/2017 CareCross Commed Roots Joining Bonitas
014/2017 Immediate CAMAF Notification of Extended Operating Hours for Medicine Authorisation Line
013/2017 01/07/2017 SABMAS Administrator Change/Option Replacement
012/2017 Immediate Cigna World Bank New Pharmacy Tariffs & Flu Vaccine Benefits
011/2017 Immediate Carecross Motohealth Pat Benefit Information reminder
010/2017 Immediate CareCross & ONECARE Confirmation of Submitting Codes for 2017
009/2017 Immediate WCMAS Flu Vaccine Price Change
008/2017 Immediate KeyHealth MMAP on Oncology and HIV and Appropriate ICD-10 on Oncology Claims
007/2017 01/03/2017 RFMCF MMAP Change
006/2017 Immediate SAB Wellness Benefit Reminder
005/2017 Immediate PICK N PAY Medical Scheme Option Termination
004/2017 01/01/2017 Information for Independent Pharmacies Not Part of PPN Default Dispensing Fee
003/2017 01/02/2017 CareCross New Selfmed Essential CareCross Option
002/2017 Immediate Bankmed Insured Pharmacy Advised Therapy (PAT) Benefit for Core Saver Members
001/2017 10/01/2017 GENERAL Payment Information
031/2016 01/01/2017 GENERAL Payment Information
030/2016 01/01/2017 (Discovery) Anglo Medical Scheme PAT Max Increase
029/2016 01/01/2017 (Universal) Compcare Plan Changes
028/2016 01/01/2017 (Universal) WCMAS New Ntsika Option Information
027/2016 01/01/2017 (Universal) Tiger Brands D4C Functionality
026/2016 01/01/2017 SAB Medical Aid Scheme Year-end Rule Changes
025/2016 01/01/2017 GEMS Year-end communication
024/2016 15/12/2016 CareCross & ONECARE Year-end Changes
023/2016 31/12/2016 Platinum Platsave Plan Termination
022/2016 01/01/2017 WCMAS Year-end Rule Changes
021/2016 01/01/2017 CAMAF Year-end Rule Changes
020/2016 01/01/2017 Profmed Year-end Rule Changes
019/2016 01/01/2017 KeyHealth Year-end Rule Changes
018/2016 01/01/2017 Bankmed Year-end Rule Changes
017/2016 14/12/ 2016 Pick n Pay Scheme Migration to New IT System & Year-end Changes
016/2016 01/12/2016 Natal Hairdressing Sick Benefit Fund Termination
015/2016 14/11/2016 CompCare D4C Functionality
014/2016 01/01/2017 GEMS New Option Information
013/2016 01/11/2016 CareCross Medicall Option Termination
012/2016 01/10/2016 GEMS MediKredit Underwriting Information
011/2016 Immediate Cigna Administrator – Reminder of Schemes Information
010/2016 Immediate Cigna Administered Schemes Famcheck Functionality Change
009/2016 01/09/2016 WCMAS Dosage Limits on Codeine Containing Products
008/2016 01/08/2016 Universal Health & Accident New Option Information
007/2016 01/08/2016 CareCross Liberty Traditional Standard Option Name Change
006/2016 Immediate Rand Mutual Important Membership Detail Information
005/2016 Immediate SAB Wellness Benefits Reminder Circular
004/2016 05/02/2016 Schemes Administered by CIGNA Dispensing Fee Change
003/2016 Immediate General New Risk Management Response (RMR) Code (7323)
002/2016 Immediate Pick N Pay Pat Max Change
001/2016 08/02/2016 RFMCF New Scheme Information
GEMS01 01/01/2016 GEMS Provider communication sms pharmacy
GEMS02 01/01/2016 GEMS Provider communication 2015 claims and queries
GEMS03 01/01/2016 GEMS destination codes for PBM claims Pharmacy
029//2015 01/01/2016 GEMS New Scheme Information
028/2015 01/01/2016 Universal Health WorkerPlan New truCare Plan Information
027/2015 01/01/2016 WCMAS Dispensing Fee Change
026/2015 01/01/2016 CAMAF HIV Tariff Increases & SAB Wellness Benefit
025/2015 01/01/2016 Momentum Health Assessment NAPPI Price Change
024/2015 01/01/2016 CareCross Year-end Changes
023/2015 01/01/2016 Pick N Pay Year-end Changes
022/2015 01/01/2016 Discovery Bankmed Option Replacement
021/2015 01/01/2016 CAMAF, Profmed year-end changes
020/2015 01/01/2016 KeyHealth Year-end changes
019/2015 01/01/2016 WCMAS, ANGLO AMS year-end changes
018/2015 17/08/2015 Platinum Health/Platinum CareCross Acute Claims Processing Change
017/2015 Immediate Bankmed New Custom Tariff Claims
016/2015 Immediate KeyHealth Acute Quantity Limits on Nexiam
015/2015 Immediate KeyHealth Quantity Limits on Sedatives, Hypnotics and Anxiolytics
014/2015 Immediate WCMAS [email protected]
013/2015 Immediate MHG Bankmed Insured Pharmacy Advised Therapy (PAT) Benefit for Core Saver Plan Members
012/2015 01/06/2015 BIMAF [email protected]
011/2015 11-28/05/2015 Rand Mutual Claims Submission and Processes Information Sessions
010/2015 01/05/2015 MHG Bankmed Quantity Limits on Agents for Smoking Cessation
009/2015 01/05/2015 MHG Bankmed Dosage Limits on Codeine Containing Products
008/2015 Immediate CareCross Flu Vaccine Benefit Increase
007/2015 immediate CareCross & ONECARE On-Line Reversal Period Change
006/2015 immediate Cigna International New Scheme Information
005/2015 17/03/2015 Cigna International Dispensing Fee Change
004/2015 Immediate Cigna International New Membership Cards
003/2015 01/03/2015 Rand Mutual Assurance Claims Submitted via MediKredit
002/2015 Immediate MMSA SAB Wellness Benefits Reminder Circular
001/2015 Immediate ANGLO AMS PAT MAX change
041/2014 01/01/2015 Vanbreda Administrator Name Change
040/2014 01/01/2015 Universal Compcare New Scheme Information
039/2014 01/01/2015 Universal Umvuzo New Scheme Information
038/2014 01/01/2015 Universal Massmart New Scheme Information
037/2014 01/01/2015 WCMAS Correction to Circular 030/2014
036/2014 01/01/2015 Universal Transmed State Plus New Scheme Information
035/2014 01/01/2015 Universal Tiger Brands New Scheme Information
034/2014 01/01/2015 KeyHealth & Profmed Pharmacy Tariff Changes
033/2014 01/01/2015 WCMAS & Anglo AMS [email protected] MK Processing
032/2014 Immediate General From [email protected] to [email protected]
031/2014 01/01/2015 CareCross & ONECARE Year-end Changes
030/2014 01/01/2015 WCMAS Year-end changes
029/2014 01/01/2015 Universal Health WorkerPlan New Scheme Information
028/2014 01/01/2015 Universal Health AECI Value New Scheme Information
027/2014 01/01/2015 Profmed , Anglo AMS Year-end Changes
026/2014 Dec/Jan2015 General Payment Date Amendment Notification
025/2014 01/01/2015 SAB, Pick n Pay Year-end Changes
024/2014 01/01/2015 Bankmed Year-end Changes
023/2014 01/01/2015 Bankmed New Insured PAT Benefit for Core Saver Plan Members
022/2014 01/01/2015 CAMAF Year-end Changes
021/2014 01/01/2015 KeyHealth Year-end Changes
020/2014 Immediate Compensation Fund Stale Claim & Reversal Period Change
019/2014 28/10/2014 Genesis Scheme Termination
018/2014 25/09/2014 General - Change of Physical Address September 2014
017/2014 Immediate CAMAF New Risk Management Response (RMR) Code (4812)
016/2014 12/08/2014 New Product [email protected] Launch During August 2014
015/2014 01/08/2014 Compensation Fund Claims Processing
014/2014 01/08/2014 Bankmed Nurses Tariff Claims and Option Name Change (Amended)
013/2014 04/07/2014 Reminder – CareCross Bankmed Wellness Benefit, Vaccines & Membership Number Information
012/2014 01/07/0214 MHG Bankmed Acute Psychiatry Medicine Management
011/2014 01/07/2014 General All schemes ICD-10 Changes
010/2014 01/07/2014 CareCross Medicall New Scheme Information
009/2014 01/07/2014 SAB New Risk Management Response (RMR) Code 4781
008/2014 01/06/2014 Bankmed Tariff Claims for Administration of Injections (0021)
007/2014 Immediate Platinum Health On-Line Reversal Period Change
006/2014 01/05/2014 CareCross New Family Care Option Information
005/2014 Immediate CareCross New Ocsacare Silver Plus (3 month waiting period) Option Information
004/2014 30/04/2014 Afrox Scheme Termination (Merger with Discovery)
003/2014 01/04/2014 Vanbreda World Bank Co-payment Changes
002/2014 Immediate MHG Bankmed Oral contraceptive processing
001/2014 Immediate Anglo AMS New Risk Management Response (RMR) Codes (4748, 4749)
028/2013 01/01/2014 Anglo AMS Stale Claim Period Claims Management
027/2013 01/01/2014 CareCross & ONECARE Year-end changes
026/2013 31/12/2013 Resolution Scheme Termination
025/2013 01/01/2014 SAB Year-end Changes
024/2013 01/01/2014 Anglo AMS Year-end changes (New Options)
023/2013 01/01/2014 Bankmed, Afrox & WCMAS Year-end Changes
022/2013 01/01/2014 Profmed, Pick N Pay year-end changes
021/2013 01/01/2014 CAMAF & KeyHealth Year-end changes
020/2013 Dec/Jan General Payment Date Ammendment Notification
019/2013 Immediate Rand Mutual Acute Claims Processing
018/2013 Immediate Vanbreda International Schemes Dispensing Fee Change (Legislation)
017/2013 30/06/2013 Rand Water Scheme Termination
016/2013 01/07/2013 CareCross Essentialmed Termination
015/2013 Immediate Vanbreda International Schemes Validation Change
014/2013 Immediate Vanbreda International Confirmation of Options & Membership Info
013/2013 Immediate SAB Wellness Benefit NAPPI Code Change
012/2013 07/05/2013 MHG Bankmed Chronic Auth & Therapeutic Reference Pricing Phase 3
011/2013 02/05/2013 Vanbreda International Monetary Fund New Scheme Information
010/2013 Immediate CareCross MotoHealth Essential & Custom Medicine Claims Processing
009/2013 02/04/2013 VanBreda World Bank, UNV, UNDP, UNOPS, Unicef & Nestle New Scheme Information
008/2013 Immediate CareCross Flu Vaccine Benefit Change
007/2013 31/03/2013 SAPPI Scheme Termination due to Merger (with Bestmed)
006/2013 Immediate WWitbank Coalfields Flu Vaccine Change
005/2013 Immediate MMSA SAB Wellness Benefit Early Detection Claims Procedure
004/2013 Immediate MMSA SAB Wellness Benefit Immunisation Claims Procedure
003/2013 Immediate MMSA SAB & Anglo Flu Vaccine Claims Procedure
002/2013 Immediate Bankmed CareCross Wellness Benefit & Membership Number Info
001/2013 01/01/2013 CareCross ONECARE Confirmation of Nedgroup Traditional Plus Option Codes
028/2012 01/01/2013 KeyHealth & Profmed Year-end Changes
027/2012 01/01/2013 Resolution Health Year-end Changes
026/2012 12/12/2013 General Payment Date Amendment Notification
025/2012 01/01/2013 CareCross General Year-end Changes
024/2012 01/01/2013 Bankmed & Bankmed CareCross Year-end Changes
023/2012 01/01/2013 WCMAS, SAB & Anglo Year-end Changes
022/2012 01/01/2013 CAMAF, Afrox, BIMAF, Anglo & Platinum year-end changes
021/2012 02/11/2012 MHG Bankmed Chronic Auth & Therapeutic Reference Pricing Phase 2
020/2012 01/11/2012 Rand Mutual On-line Reversal Period Change
019/2012 01/08/2012 NIMAS/RESOLUTION HEALTH SCHEME MERGER
018/2012 05/07/2012 MHG Bankmed Chronic Authorisation & Therapeutic Reference Pricing
017/2012 01/06/2012 General Notification of Change in Email address for Queries or Enquiries
016/2012 01/06/2012 CareCross Platinum PAT Claims Processing Change
015/2012 Immediate CareCross Rand Water Claims Processing Change
014/2012 Immediate Agility Resolution Health New Risk Management Response (RMR) Codes (2729, 2730)
013/2012 01/05/2012 CareCross Platinum Acute & PAT Claims Processing (RMR 2579
012/2012 06/04/2012 General Medikredit Payment Date Amendment Notification
011/2012 01/04/2012 SABMAS Plan name changes
010/2012 16/03/2012 General MediKredit Payment Date Amendment Notification
009/2012 31/03/2012 World Bank Termination
008/2012 Immediate SABMAS Wellness Benefit Immunisation
007/2012 Immediate CareCross Various Schemes Flu Vaccines
006/2012 Immediate Resolution Oncology and Renal Failure Medicine Claims
005/2012 Immediate Rand Water New Plan Information
004/2012 01/02/2012 Mamoth Health New Scheme Information
003/2012 Immediate CareCross ONECARE Confirmation of Submitting option codes
002/2012 01/02/2012 Rand Mutual Surcharge/MMAP Change
001/2012 Immediate Anglo PAT Claims for Standard Plan Members incorrectly Rejecting
042/2011 01/01/2012 Resolution Health & EMC Year-end Changes
041/2011 01/01/2012 Carecross & Platinum Health Year-end Changes
040/2011 01/01/2012 Bankmed & Afrox Year-end Changes
039/2011 01/01/2012 KeyHealth, CAMAF & SAPPI Year-end Changes
038/2011 01/01/2012 WCMAS, Rand Water & Foschini Year-end Changes
037/2011 26/11/2011 SAMWUMED Scheme Termination
036/2011 Immediate General Voluntary withdrawal of Xigris® 20mg & 5mg
035/2011 01/11/2011 Profmed Option Code Consolidation
034/2011 Immediate CareCross Prosano Procedure Oncology, Renal Dialysis & Organ Transplant Claims Processing
033/2011 Immediate PMSA Profmed Famcheck Functionality
032/2011 Immediate ProfMed Contraceptive Claims Processing
031/2011 01/10/2011 Carecross Essentialmed Member Number Change
030/2011 26/09/2011 Resolution Switch-out Project (CI116)
029/2011 29/09/2011 Voluntary withdrawal of Avandia 2mg and 4mg
028/2011 16/09/2011 General New Risk Management Response (RMR) Code (2426)
027/2011 Immediate MHG Bankmed Healthcare Claims Processing
026/2011 Immediate General New Risk Management Response (RMR) Code (2425)
025/2011 Immediate PMSA KeyHealth Validation Change/Famcheck Functionality
024/2011 Immediate General Changes to Claims Audit Procedures
023/2011 01/08/2011 Anglo Medical - New Risk Management Response (RMR) Code (2423)
022/2011 01/08/2011 MHG Medipos Scheme Termination
021/2011 Immediate General All Schemes New Risk Management Response (RMR) Code (2420)
020/2011 01/07/2011 MMSA Anglo Medical Standard Plan PAT Benefit
019/2011 24/06/2011 MMSA KeyHealth Administrator Move to PMSA
018/2011 30/04/2011 Cape Medical Plan - Termination
017/2011 01/04/2011 Platinum Health PAT Claim Max Change
016/2011 Immediate ONECARE Claims Processing
015/2011 Immediate SABMAS Flu Vaccine Claims
014/2011 01/03/2011 MHG Foschini Dispensing Fee Change
013/2011 01/03/2011 Best Gold Select ONECARE Claims Processing
012/2011 14/02/2011 Voluntary Withdrawal of Zamanon 100mg IV
011/2011 28/02/2011 CareCross Medshield Essential Plan Termination
010/2011 01/03/2011 SAMWUMED - Optipharm DSP for HIV Medication
009/2011 01/01/2011 CareCross Prosano & Topmed PAT/OTC Benefit Change
008/2011 04/02/2011 CareCross Day 1 Health & KeyHealth HIV DSP - RMR 2287
007/2011 01/02/2011 Platinum New PAT Option
006/2011 01/02/2011 Option List for February 2011
005/2011 01/02/2011 General Summary of Circulars for January 2011
004/2011 01/01/2011 Option List for Mid-January 2011
003/2011 01/01/2011 General Summary of Circulars until Mid-January
001/2011 01/01/2011 CareCross ONECARE Claims Processing
001/2011 01/01/2011 Resolution Foundation Plan Claims Processing

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