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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 - 2018

Physiotherapy Services, Occupational Therapy Services and Chiropractor Services

General Information

Billing Procedure

 

1. All service providers should be registered on the Compensation Fund electronic claims system (Umehluko) in order to capture medical reports.
1.1 Medical reports should always have a clear and detailed clinical description of injury.
1.2 In a case where a procedure is done, an Operation report is required
1.3 Only one medical report is required when multiple procedures are done on the same service date.
1.4 A medical report is required for every invoice submitted covering every date of service.
1.5 Service providers are required to keep original documents (i.e medical reports, invoices) and these should be made available to the Compensation Commissioner on request.
1.6 If there' s any referrals to another medical service provider, it should be indicated on the medical report.

 

2. Medical invoices should be switched to the Compensation Fund using the attached format. - Annexure D.
2.1 Subsequent invoice must be electronically switched. It is important that all requirements for the submission of invoice, including supporting information, are submitted.

 

3. The status of invoices/claims can be viewed on the Compensation Fund electronic claims system. If invoices are still outstanding after 60 days following submission, the service provider should complete an enquiry form, W.C1 20, and submit it ONCE to the Provincial office /Labour Centre. All relevant details regarding Labour Centres are available on the website www.labour.gov.za.

 

4. If an invoice has been partially paid with no reason indicated on the remittance advice, an enquiry should be made with the nearest labour centre. The service provider should complete an enquiry form, W.CI 20, and submit it ONCE to the Provincial office/Labour Centre. All relevant details regarding Labour Centres are available on the website www.labour.gov.za.

 

5. Details of the employee's medical aid and the practice number of the referring practitioner must not be included in the invoice.

 

6. Service providers should not generate the following:
(a) Multiple invoices for services rendered on the same date i.e. one invoice for medication and a second invoices for other services.

 

* Examples of the new forms (W.C1 4 / W.C1 5 / W.C1 5F) are available on the website www.labour.gov.za.