Pula Discusses Cross-border Transfers With Members

PATRICIA MAGANU
Staff Writer | Monday March 15, 2010 00:00

Members and the Fund were meeting at Marang Hotel here over breakfast on Friday.  Members complained that cross-border transfers were a problem as hospitals in South Africa had many demands, including asking for hefty payments upfront and delaying claims.

Dr Kgosidialwa Mompati of Riverside Hospital in Francistown said they were experiencing problems transferring patients to South Africa.

'It has always been a hassle to transfer across the border,' he said.

They were also having problems getting claims from Pula and that the Fund was not communicating the source of the delays with them. Pula should be transparent with their members if the Fund should become a leader in the field, Dr Kgosidialwa said.

Dr Dorcus Mompati, also of Riverside Hospital, said as service providers, they wanted to know what Pula had in place in South Africa as they were having trouble transferring patients there.

'What does Pula have in place that side because sometimes our patients are told to pay upfront?' she asked. A member, Batho Seboni, also complained about difficulties met by patients seeking help in South Africa.  Responding to the concerns, the Deputy Managing Director of Associated Fund Administrators (AFA), Rose Tatedi, said they appreciated the feedback and were aware of some of the problems.

She said that because of the backlog in claims, some hospitals were not keen to help.

'If you are in South Africa and you find yourself in that situation, call us and we will be able to resolve that,' she said. She added that Pula members should also have the MedRescue number in case they encounter problems after hours.

'They have our cellphone numbers and they can call us any time, even at midnight,' Tatedi said. 'We can even write (a) letter at any time and send it to the hospital.'

She said the claims backlog was caused by a new system they introduced in June 2009. 'We have given ourselves the deadline for March 31 to have finished with the claims,' she said, adding that practitioners should use an improved format for claims recently introduced.

'Those who have complied have been receiving their claims rather than those who have not been complying with the requirements,' said Tatedi.

She said in another attempt to alleviate the problems affecting patients seeking help in South Africa, Pula had recently contacted the vendor of the new hospital system because the problems do not only stem from Pula.

'We want to make sure hospitals do not ask for those exorbitant co-payments from our clients,' she said. Pula has a direct arrangement with hospital groups in South Africa, namely, Netcare, Mediclinic and Lifehealthcare.Tatedi said she had scheduled meetings with those hospital groups for this week.

'We have confirmed dates for Netcare and still await for confirmation from the other two,' she said.

Members and Pula agreed that Bokamoso Private Hospital could be the answer to the problems encountered by patients and practitioners at South African facilities.