Hospital Admittance
HOSPITAL MANAGEMENT
Universal Care offers a complete hospital utilisation management service. It is the member’s responsibility to ensure that all non-emergency hospital admissions are authorised. These must be authorised at least 48 hours prior to admission. The member, doctor or hospital may phone in for this authorisation. A penalty will apply for late requests for authorisations. Emergency admissions must be authorised on the first working day after admission. There will be a penalty if the member does not obtain authorisation. This service also applies to Oncology treatment.
MEDICINE CLAIMING PROCESS
Mediscor provides a real time processing of medicine claims and members may obtain their medicines from any pharmacy linked to Mediscor.
The scheme reimburses medicines at a specified dispensing fee tariff. The scheme has negotiated preferred dispensing fee arrangements with various pharmacy groups. These pharmacy groups have agreed to provide medicines at the preferred dispensing fee. You may choose to obtain your medicines from any of these Preferred Pharmacies or you may also obtain your medicines from the pharmacy of your own choice. If your pharmacy charges a higher dispensing fee than the scheme’s specified dispensing fee, the difference will be funded by the member.
The pharmacy groups that provide medicines at the preferred dispensing fee include:
- Alpha Pharm
- Clicks
- Dis-Chem
- Link
- MediRite
- Opti-Me
- Pick n Pay
- Script Savers
Members may also make use of the following courier pharmacies:
- Chronic Medicines Dispensary (CMD)
- Clicks
- Direct Medicines
- Optipharm
- Medipost