Advice to patients
Excessive radiology examinations not only lead to being exposed to excessive amounts of radiation, but also increase your medical accounts.
Radiology examinations may not be funded by your Medical Scheme if performed without a doctors referral letter.
Specialists, ie. Neurosurgeons, Orthopaedic surgeons etc. Requests specific examinations, thus basic x-rays may be deemed redundant as they usually have this information, if it’s not your first visit to the Specialist. Also, if you have had the standard x-ray previously, and your GP refers you to the Specialist – there is no need for the standard x-rays to be repeated. Advise your Specialist that standard x-rays have been done, and he/she may be aware to only request specialized views.
Radiology Practices have radiology protocols of standard views which they perform for particular areas of interest.
Standard views for first time visit referred by a General Practitioner for Lower Back x-rays (Lumbar Spine x-rays) are 3 views of the spine. Some practices add a pelvis as well as flexion and extension without those views being requested. A more common example is a GP adding extra knee views that should only be requested by an orthopaedic surgeon.
The Radiology Request Form is the legal document submitted to the Scheme for assessing claims. The information on these request forms drives the payment of such claims. Should any add on examinations be requested by yourself or additional examinations performed by the Radiology Practice that are not motivated for or deemed necessary, payment may be declined by the Scheme.
Excessive radiation is harmful. Ask your doctor to be specific with the x-ray requests in order to prevent unnecessary irradiation and excessive medical claims.
Medical inflation in South Africa is consistently higher than the general levels of inflation in the South African economy. Although pathology tests are an essential part of modern medicine there are steps that you can take to insure that you are correctly billed only for the tests your doctor specifically requests
What you can do about Pathology testing and its costs
Remember that excess and unnecessary testing increases the account. This account is either your responsibility or that of your medical aid. The costs if borne by the medical aid are eventually paid for by you via increased contributions
When your Doctor orders lab tests - Ask them how much this should cost - remember its your money! Ask if all of these tests are necessary?
Ask if your Doctor if he/she receives any financial advantage as a result of this referral?
Ask why the Doctor prefers a certain Laboratory?
There are Medical Technologist laboratories available in South Africa that charge 26% less for tests. In addition these labs are not allowed to perform "shopping lists of tests", these profiles increase the costs of pathology testing.
Have you had these tests recently, if so must they be repeated? When you are referred from a GP to a specialist ask the GP to send all relevant lab results with the referral. This may prevent unnecessary and costly repeats. Point out to the specialist that you have previously had lab tests performed.
Ask the lab to give you a copy of the request form when they take the blood or other specimen for your tests. This request form should be designed according to National Pathology Group guidelines. Some Pathology labs may automatically add on extra tests to those that the Doctor ordered. Some Pathology labs may not adhere to the profiles as set by the National Pathology Group.
If the account arrives and the amount is different from that which your Doctor indicated then ask your Doctor to explain the difference. If necessary the Doctor should phone the laboratory to confirm the account.
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