Durban Retinal AssociatesDurban Retinal Associates

At present, there is no “Reference Price List” and thus there is no single medical aid rate any longer.  This makes the administration of your billing difficult to understand and at times, difficult for our practice staff to implement.  At this time, each medical aid offers a fee structure (known as the ‘Scheme Rate’) for their members.  This is not a negotiated rate, but rather a unilateral offering by your scheme which is detailed every year in your membership booklet. Each scheme will pay specialists a rate which is outlined in your guide, and each plan within your fund will pay different rates.  It is therefore important for you as the patient to carefully select a plan that suits your needs, and that of your dependents.

We base our charges on Practice Cost Studies which were provided to the Department of Health by the Ophthalmological Association of South Africa, and  were audited and  accepted by them some years ago.  We will provide you with a detailed pricing structure and remain committed to keeping costs contained at all times. We hope to avoid all out of pocket expenses, and will assist you with ensuring that you have the correct information to make the financial aspects of your treatment a small consideration.

Please Note:

We, as the medical specialists in South Africa, are not legally able to have a payment contract with any medical aid institution. Instead, we have a contract with you as the patient, and in turn you may choose to insure your care with your Medical Aid Fund.

It is important to understand, that almost all of the conditions that we treat in this practice are listed as Prescribed Minimum Benefit or PMB conditions. This ensures that you, as the patient, are protected by a set of legal rules that guide the payment of your treatments for these PMB conditions and in many cases will protect you against out of pocket expenses with current legislation. An information pack about PMB conditions is available along with our detailed billing guide. We have efficient administrative staff who are available at all times to advise and assist.

Lastly, we believe that we run a highly professional service and welcome your feedback and queries at any time.