Billing Policy

Swartland Medical Centre (Tuinstraat Mediese Sentrum Inc, Practice Number: 1563718) is registered with most major South African medical aid schemes. We bill directly to your medical aid on your behalf. You will be asked to present your medical aid card and membership number at the time of your consultation. Your responsibilities: • Ensure your medical aid is valid and up to date • Notify us of any changes to your medical aid membership • You are responsible for any shortfall, co-payment, or amount not covered by your medical aid • Self-payment day cards and benefit limits are your responsibility to track Medical aids we accept include (but are not limited to): Discovery Health, Discovery KeyCare, Medshield, Bonitas, Momentum Health, Fedhealth, Sizwe, CompCare, GEMS, Polmed, and others. Please contact our billing administrator at accounts@drsnnb.co.za or 022 482 2552 to confirm your specific medical aid is accepted.

Private patients are welcome at Swartland Medical Centre. Payment is due at the time of consultation. We accept: • Cash • Credit/debit card (FNB card facility) • EFT (prior arrangements with billing office required) Our consultation fees are based on the South African Medical Association (SAMA) recommended fee tariff and current market rates. Fees are reviewed annually. Schedule of consultation types: • Standard consultation (15–20 min) • Extended/complex consultation (30+ min) • Emergency consultation • Procedure room consult • Chronic review visit • Nursing/clinic visit Exact fee schedules are available from our reception team. Private patients receive an official receipt and invoice for any medical aid reimbursement claim they wish to submit independently.

All billing at Swartland Medical Centre uses the internationally standardised ICD-10-CM diagnostic codes and NHRPL (National Health Reference Price List) procedural codes. This ensures accurate communication with medical aid schemes and compliance with South African Health Products Regulatory Authority (SAHPRA) and Board of Healthcare Funders (BHF) billing requirements. If you have a query about a specific code or charge on your invoice, please contact our billing administrator who will explain the coding and rationale.

As a licensed dispensing practice, we charge a dispensing fee in addition to the cost of medication. This is in accordance with the Single Exit Price (SEP) regulations for medicines in South Africa. For medical aid patients: Dispensing fees are typically covered by your medical aid's chronic medicine benefit or medicine benefit. For cash/private patients: The dispensing fee and medication cost will be included in your invoice. Generic substitution: Where clinically appropriate and legally permitted, we may offer generic alternatives to reduce your out-of-pocket cost. We will always discuss this with you.

Injury on Duty (IOD) consultations are billed to the Compensation Commissioner (Workmen's Compensation) or the patient's employer, as appropriate. For IOD claims: • Your employer must provide a WCL.2 form (First Medical Report) • We complete the WCL.4 (Medical Report) and WCL.22 (Progress Report) as required • Rand Mutual Assurance and other compensation funds may have specific billing requirements Private employers booking occupational health services (pre-employment medicals, fitness for duty, food handler certificates) are billed according to our occupational health fee schedule. Contact us for group bookings and corporate arrangements.

Accounts that remain unpaid after 30 days may be referred to our collection process. We ask that you contact our billing team proactively if you are experiencing financial difficulty — we will do our best to arrange a suitable payment plan. Please note: • Repeat consultations may require settlement of outstanding accounts before a new consultation is booked • We reserve the right to charge interest on accounts overdue by more than 60 days • Accounts referred to debt collection will incur additional costs Billing queries: accounts@drsnnb.co.za | 022 482 2552 (ask for billing)

If your medical aid partially pays or rejects a claim, Swartland Medical Centre will assist you in understanding the reason for non-payment. However, the patient remains ultimately responsible for the outstanding balance. If you believe a claim was incorrectly rejected: • Contact your medical aid directly with your reference number • Request a review or appeal through your scheme's internal complaints process • If unresolved, contact the Council for Medical Schemes (CMS) at 0861 123 267 or www.medicalschemes.com We are not responsible for medical aid scheme benefit limits, exclusions, or co-payments.