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Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2023

Optometry Gazette 2023

Requirements for Switching Medical Invoices with the Compensation Fund

 

The switching provider / third party must comply with the following requirements:

 

1. Register with the Compensation Fund as an employer.

 

2. Host a secure FTP (or SFTP) server to ensure encrypted connectivity with the Fund. This requires that they ensure the following:
a. Disable Standard FTP because is now obsolete....and use latest version and reinforce FTPS protocols and TLS protocols
b. Use Strong Encryption and Hashing.
c. Place Behind a Gateway.
d. Implement IP Blacklists and Whitelists.
e. Harden Your FTPS Server.
f. Utilize Good Account Management.
g. Use Strong Passwords.
h. Implement File and Folder Security
i. Secure your administrator, and require staff to use multifactor authentication

 

3. Submit and complete successful test file after registration before switching the invoices.

 

4. Validate medical service provider's registration with the Board of Healthcare Funders of South Africa.

 

5. Submit medical invoices with gazetted COIDA tariffs that are published annually.

 

6. Comply with medical billing requirements of the Compensation Fund.

 

7. Single batch submitted must have a maximum of 100 medical invoices.

 

8. Eliminate duplicate invoices before switching to the Fund.

 

9. File name must include a sequential batch number in the file naming convention.

 

10. File names to include sequential number to determine order of processing.

 

11. Medical Service Providers will be subjected to Compensation Fund vetting processes.

 

12. Third parties must submit a power of attorney.

 

13. Submit any information/documentation requested by the Fund.

 

14. Only pharmacies should claim from the NAPPI file.

 

Failure to comply with the above requirements will result in deregistration/penalty imposed on the switching house.