Background

The owners and directors of National Pathology Consulting Group (Pty) Ltd and Verirad (Pty) Ltd are Chris Adams and Paul Horn. The directors South African citizens.

Chris Adams is a highly qualified and experienced pathology laboratory manager with 18 years experience in a major pathology practice in Johannesburg South Africa. Prior to joining the private sector he was employed at the South African Institute for Medical Research. Adams is a member of the SAMLTS and is a Medical Technologist - Clinical Pathology, Chemical Pathology, he holds a B Comm degree (UNISA), Post Graduate Diploma Health Economics (UCT) and an MBA from Brunel University (U.K.) / Henley Management College.

Paul Horn has a BSc in Mathematics and Statistics and has 15 years experience in Commercial IT development.

Verirad employs a Consultant Radiologist and Pathologist together with qualified radiographers and Medical Technologists for the assessing and verification of radiology and pathology accounts. All have extensive experience in both private practices and in an administrative or consulting capacity with various Medical Schemes/Administrators or Managed Healthcare Companies. An IT Systems Product has been developed, the rules of which are based on a combination of: -

• RSSA
• NHRPL
• ICD10 coding
• DoH
• CMS
• HPCSA
• NPG
• BHF
• SAMA

Verirad has identified a number of areas where erroneous billing and over-servicing are performed by Radiology and Pathology practices:

Duplicate submissions and/or payments

Up-coding of tariffs

Tariff combinations

Comparison views

Unbundled Group Tests

Overcharging of consumables and contrast medium

Inappropriate tariffs

Increased utilization

Elective medicine