Patient Terms & Conditions

1. Informed consent

I understand that I have the right to ask my doctor to explain and disclose medical information to me before I agree to a medical procedure or treatment, including the following:

• Different treatment options available to me;
• Common and severe side effects of specific treatment options; • the benefits, risks, costs, and consequences associated with each option; • details of the diagnosis and prognosis, and the likely prognosis if the condition is left untreated;
• Any uncertainties regarding the diagnosis;
• How and when my condition and any side effects will be monitored or re-assessed;
• The name of the doctor who will have overall responsibility for the treatment; • that I have the right to seek a second opinion at any time;
• And I confirm that this information has been provided to me.

2. Generic medicine

I understand and acknowledge that my Medical Scheme may insist that I substitute medicine that appears on my prescription with its generic equivalent. It is within my doctor’s sole discretion and clinical judgement whether or not to allow for the generic substitution of my medicine and no substitution may take place where the doctor has written ‘no generic substitution’ on my prescription.

3. Disclosure of medical information

I hereby authorise:
• The use and disclosure of my medical information to any healthcare provider and relevant online medical registries as my primary doctor may see fit;
• That a copy of my medical record will be kept by my doctor on file. I am aware that all consultations and interaction with the doctor are subject to audio and visual recording and electronic storage, and copies will be stored in a secure server as part of practice note-keeping for the personal use of the doctor;
• The disclosure of relevant medical information to my Medical Scheme and third parties assisting with medical claims processing and practice management; this information typically includes diagnoses, ICD10 codes and procedural codes;
• The practice to have access to my hospital, radiology & laboratory records.

4. Privacy of medical information

I understand that this practice and its associated data handling entities have implemented reasonable security measures to guard against the unauthorised disclosure of my information and that I may revoke my authorisation at any time. I will inform Dr Lamprecht if I intend to make any audio or visual recording during any in-person or telephonic interaction with the practice.
My patient information may be disclosed by this practice, without my consent, in response to a specific request by a law enforcement agency, subpoena, court order, or as required by law.

5. Payment of medical costs

I acknowledge that:
• I have been informed that this practice does not necessarily charge the rates that my Medical Scheme may have decided upon;
• My Medical Scheme may or may not cover all the fees charged by this practice. Should there be a shortfall, I remain personally liable for payment of that shortfall.
• I undertake to settle all fees incurred through elective or emergency consultation, deliveries, procedures, or care otherwise provided, irrespective of my agreement with my medical Scheme. If there is any delay or dispute (by my insurer or others)
Regarding payment, I undertake to settle the account personally within 30 days of services rendered.
• I am fully responsible for payment and should I not pay timeously, I will be liable for debt recovery & legal costs;
• I am also aware that there will be annual increases in practice fees for all consultations, deliveries and procedures, and that unless a formal quotation for a specific procedure is accepted in writing by both client and provider, these cost increases will apply to all patients (usually effective 1 January of each year).

6. Interest on overdue accounts

I am aware that 2% interest and administrative costs will be charged per month (after 60 days) for all overdue accounts and that legal steps will be taken by the practice with any additional costs incurred to be added to my account.

7. Medical certificates (‘sick notes’)

I hereby acknowledge that I understand that although I am entitled to ask for a medical certificate from my doctor, he/she is under no obligation to issue such a certificate. My diagnosis will only be disclosed on the certificate provided I have given my written consent, and the decision of who I want to show the certificate to is at my sole discretion.

8. Pre-authorisation

I am fully aware that if a treatment requires hospitalisation, I am personally responsible for ensuring that pre-authorisation is obtained from my medical scheme BEFORE I undergo the procedure. If my medical scheme declines payment for any reason whatsoever, I remain responsible for making full payment for the services rendered to me. My Medical Scheme may request information or a formal motivation from my doctor before authorising the procedure. I acknowledge that I am responsible for paying for the costs of such motivation or information supplied
to my medical scheme.

9. ICD-10 diagnostic coding

Regulation 5(1) of the Medical Schemes Act (Government Gazette NO 20566 on October 20th, 1999) states that an account to the Medical Scheme must contain the relevant diagnosis in the form of an ICD-1 O diagnostic code (number allocated to your diagnosis by the international classification of diseases) and may be used in referral letters, requests for special investigations and prescriptions. Failure to submit the correct codes might lead to a claim being incorrectly paid or not paid at all.

10. Medical research

I understand that diagnostic and procedural information (as well as any related audio and visuals) related to my treatment may be utilised for relevant online medical data registries, practice statistics, research and/or teaching purposes. All such information will be dissociated from patient information and informed consent will be obtained by the practice if any of my information is required for clinical trials or research. I have the right to decline the taking of photography or the use of any images by the practice.

11. Consent to process personal information

I acknowledge that my personal information needs to be processed by the practice and therefore grant the following consent:

I acknowledge and accept that the medical practice will during the course of rendering services to me, collect and access my personal information, including information relating to my race, gender, sex, pregnancy, marital status, national, ethnic, or social origin, colour, sexual orientation, age, physical or mental health, well-being, disability, religion, conscience, belief, culture, language, identifying number, symbol, e-mail address, physical address, telephone number, location information, online identifier and my biometric information.

I grant my express consent for the practice to collect and process this information for the purpose of rendering services to me as well as processing claims with medical schemes or insurance funders and with the help of third-party entities registered for assistance with these processes.

Administrative staff employed in the practice may be granted access to my personal information contained in my health record, including any clinical notes, in order to process claims to medical schemes, issuing of documentation or any other administrative function required by the practice. This includes a maximum of two requests for online reviews by patients.

The practice makes use of a medical billing service company, namely Xpedient Medical (Pty) Ltd, as well as authorised third party entities including Healthman (Pty) Ltd, the Ophthalmology Management Group (OMG) (Pty) Ltd for the authorisation, settling and disputing of claims, and I grant my consent to the processing of my medical information by these companies as is required to process claims with medical schemes.

I accept that my personal information will be accessed by my Medical Scheme and/or health insurer and grant the practice and the above-mentioned third parties consent to transmit that information to process any claims.

I accept that my personal information will only be utilised for the purpose it was collected for,and that the information will only be retained for as long as is necessary and required by law, and that I have the right to view such information at any time.
GENERAL