Frequently Asked Questions
1. What is Healthchoice?
Healthchoice is a set of Primary Care Physician Networks managed by an accredited managed care company contracted by certain IPA's.
2. Will there be any profiling and peer review on the Healthchoice Networks?
Yes, profiling and peer review will occur on the Healthchoice Networks.
3. How will the profiling and peer review be done?
Healthchoice will conduct profiling and data analysis independent of any
medical scheme and will perform the profiling via accredited and
experienced doctors, again independent of any medical scheme.
4. How do I sign up?
Simply register your details on the website.
5. What are my obligations when I contract to provide services via the Healthchoice
capitation model?
You will be required to see patients registered against your practice
for an annual checkup and then as often as clinically necessary. You
will also be required to dispense and/or prescribe medication using the Healthchoice formulary and refer members to specialist disciplines, using the Healthchoice recommendations where appropriate.
6. What data will my practice need to capture when I see capitated
patients?
Your practice will be required to capture all the relevant fields
on the Patient Visit Capture Screen within 1 week of the consultation. To view a screenshot of the Patient Visit Capture screen click here.
7. How will I get paid?
Currently medical schemes make payment to providers via their contracted
administrators. Healthchoice providers will continue to be paid by
the schemes administrators except you will receive monthly capitation
payments rather than fee-for-service payments.
8.What differentiates the Healthchoice Network solutions from other
networks?
The Healthchoice Networks aim primarily to cut out the middle-man. As
this initiative will be run by a managed care company owned by the Primary Care Physicians working in the Network, there is no middle-man to dilute the shareholders 'returns'.
This managed care company will be free to offer managed care and other services to medical schemes and generate additional returns for Primary Care Physicians.
