TZANEEN: Fixed fee according to triage at Mediclinic’s Emergency Centre

Disgruntled residents of Tzaneen feels that Medical attention costs at Mediclinic’s Emergency Care Centre are out of bound and letters of concern reached Letaba Herald’s office.

Some voiced their opinion on social media for some time now, and other mutters in disbelieve and even in anger when they receive their bills, after visiting the Emergency Centre, only to find out that their medical aids do not make provision for covering the costs, or that the billing seems extremely high.

Letaba Herald asked Mediclinic to shed some light on the community’s concern to explain how patients are billed accordingly for medical services rendered at the Emergency Centre.

Dr Ig van Rensburg, Chairman of the Board, Mediclinic Tzaneen responded to Letaba Herald’s enquiry.

Van Rensburg hopes that the following explanation will be helpful:

“Since July 2017 Mediclinic Tzaneen has contracted with an independent medical practice to provide emergency services to its patients in the Emergency Centre and to inpatients admitted to the hospital with an emergency doctor available in the Emergency Centre 24 hours per day.

This step was caused by the need to render a faster and more efficient service to patient emergencies.

Before that Mediclinic Tzaneen had a “doctor on call” system where doctors were not on site and had to be called from their rooms during the day and from home after hours to attend to emergencies. This situation was not ideal as it often lead to delays in patient care.

This is also in keeping with national and international standards in the running of an Emergency Centre and is the norm in most Mediclinic Hospitals.

In the case of Mediclinic Tzaneen the hospital awarded the tender to render the emergency service in the Emergency Centre to Middleton and Partners t/a Tzaneen Emergency Care.

Tzaneen Emergency Care is owned and managed by 12 general practitioners who rotate shifts in the Emergency Centre and render their services independently of Mediclinic Tzaneen and all other medical service providers. The 12 emergency doctors have had additional training in emergency medicine and subscribe to continued professional development in this field of medicine.

Patients presenting to the Mediclinic Tzaneen Emergency Centre are firstly evaluated by a registered nurse or an enrolled nurse, formerly known as sisters and staff nurses, who are specifically trained in this field. They will take a short history, do a basic examination including vital signs and then triage patients according to their findings. Triage means sorting patients according to the acuity of care needed, based on an international triage score taking into account the complaint, history, age of the patient, vital signs and general examination.

Patients are then sorted in four different categories, red, orange, yellow and green. The level of acuity of care needed is also in that order and patients will be attended to by the emergency doctor according to their triage and not necessarily in order of arrival.

Patients are billed for services by each independent service provider separately.

Mediclinic Tzaneen bills patients according to their triage and is based on the level of care provided by the hospital and its staff.

The fee payable to Mediclinic Tzaneen includes the fee for use of its facility and staff, any disposable items used for the diagnosis or treatment, including tongue depressors, syringes, needles, sterile equipment, local anaesthetics, suturing materials, dressings, bandages etc. and medications dispensed.

Mediclinic Tzaneen bills a fixed fee according to triage.

Green patients pay the minimum, yellow patients more, orange patients more and red patients the maximum. This is based on the premise that the higher the triage, the more equipment is used and the higher the fee is.

Middleton and Partners/Tzaneen Emergency Care bills patients independently for their professional fees including consultative services and procedures performed.

These fees will differ from patient to patient according to the service rendered but will at least include a consultation fee.

These consultation fees are significantly less than before July 2017, as the doctor does not have to travel to the hospital and charges a reduced fee for being in the Emergency Centre already.

It must be remembered that any additional service providers needed will also render additional fees.

The pathology laboratories, radiology department and medical specialists are all also independent service providers and will render additional accounts for services provided when needed.

Important to notice is that different medical aids and even different options of the same medical aid have different rules and benefits.

Some medical aids pay fully for Emergency Centre visits while some do not pay at all, which makes the member liable for the bill.

Members of medical aids should make sure of their benefits provided. Mediclinic Tzaneen and Tzaneen Emergency Care are contracted to most medical aids and are able to tell patients if their medical aids will cover the costs directly or whether they are required to pay themselves for services rendered.

Neither Mediclinic Tzaneen nor Tzaneen Emergency Care will refuse any patient a proper assessment and emergency care based on their ability to afford further treatment.

Once the emergency is managed the cost of further care and management is discussed with each individual patient and their families.

Patients presenting to an Emergency Centre at a private hospital should realise that there will always be costs involved.”