Provider Network Management Services

The South African Medical and Dental Practitioners

Restriction of Choice

This means all the schemes should allow Balance Billing to ensure that patients see providers of their choice. As IPAF and SP Net we are pushing hard to have this right recognized by all the schemes.

Risk Sharing – Capitation

Inherently in these prepayment arrangement is the risk of underservicing. Therefore utilisation reviews; practice profiles and peer reviews should be a prerequisite.

Acknowledgment of debt

Doctors are often coerced into signing it – withhold of payment by schemes that then affects doctor financially.Think the matter through before signing any (Admission of guilt).contact our office if you are facing this challenge.

About us

SAMDP Provider Network (SP Net) is a national network of medical providers representing more than 21 affiliated Independent Providers Associations (IPAs), and more than 1 100 General Practitioners (GPs) spread all over the country.

The South African Medical and Dental Practitioners (SAMDP) is an organization representing medical providers countrywide, including doctors in the public and private sector, plus the army. It represents black doctors in the South African Medical Association (SAMA). It is a Section 21 company that has an association with SP Net.

SPNET

Relationship to Medical Aid 95%

Communication 98%

Implementation 85%

Market Reach 90%

Planning 75%

Brief history of SP Net

SP Net has been operational since 2001 and has contracts with a number of medical aid schemes and administrators like. It has a contract (PPP) with the South African Social Services Agency (SASSA) whereby SP Net doctors provide Disability Grants (DG) and Care dependency Grants (CDG) assessments.

SP NX Management

SPNX Management Services (SP NX), is registered as a Pty Limited, and provides services on behalf of SP Net. It has contracts with medical schemes; administrators and government.

SP Net

SP Net is an association of 21 Independent Providers Associations (IPAs) that are represented at SP Net by their various chairpersons to form the Board of Governors (Governing Council) of SP Net.

Committee design

Each IPA has its own executive committee. These IPAs are contracted to SP Net and their doctors benefit from the contracts negotiated by SP Net on behalf of its affiliates. Individual doctors from the various regions are affiliated to these IPAs on a regional basis. Provinces covered by this network include Gauteng, Limpopo, Northwest, Mpumalanga and the Free State.

Fraud perpetrated

Phantom billing

Ghost claims

Falsification of information in medical records;

Billing for meds not dispensed

Billing for supplies not provided

Billing for a PMB condition when it is not a PMB

Unbundling – adding multiple claim lines

Corporate governance

SP NX is committed to the principles and implementation of good corporate governance. The company recognises the valuable contribution that it makes to long-term business prosperity, to ensuring accountability to its members, shareholders and to all its affiliated providers to developing and sustaining effective relationships with its stakeholders.

Unnecessary hospital admissions

Office procedures that could be done by FPs at a fractional cost being done in hospitals by Specialists. When done in FP/GP office, schemes pay for these from acute benefits or the Medical Savings Account (MSA) thus disadvantaging patients. We can draft a list of procedures that can be doneby FPs in theiroffice; and to incentivize them, schemes should pay a higher rate, as they will be saving on hospital costs.

SP Net is against any form of Fraud, Waste and Abuse of medical resources as this leads to increased cost of care, which leads to lots of people being unable to afford private care. We urge our members to exercise care and caution when providing medical services and claiming from schemes for services rendered.

FRAUD (Intentional) -This is an intentional wrongful or criminal deception intended to result in financial gain:

Unlawfully making a misrepresentation that prejudices another

Conferences

The APG Annual Conference features industry leaders speaking on the latest issues concerning physician groups providing coordinated, capitated care.

image

SPNET

image

Project title here

image

Project title here

image

Project title here

image

Project title here

image

Project title here

A goal is a dream with a deadline.

— NAPOLEON HILL

Medipro PMA and EHR

Our completely offline solution caters for all your practice management requirements and is operated completely offline and only need the internet for sending claims to medical aid.Enjoy real-time submission and verification of claims and authentication of medical aid membership details. visit www.medipro-sa.co.za for more details

How to Improve Patient Satisfaction

You'll learn how to improve patient satisfaction quality scores and enhance patient engagement at your organization. Gain valuable insights on how patients truly feel about their healthcare, and leverage this knowledge into actionable steps for your entire care team.

+-900

Phycisians

221

Happy clients

131

awards win

Client testimonials

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce vitae risus nec dui venenatis dignissim. Aenean vitae metus in augue pretium ultrices. Duis dictum eget dolor vel blandit.

Pricing plans

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce vitae risus nec dui venenatis dignissim. Aenean vitae metus in augue pretium ultrices. Duis dictum eget dolor vel blandit.

R400 monthly

Standard

  • 50 GB Disk Space
  • 50 Email Accounts
  • 50 GB Monthly Bandwidth
  • 10 Subdomains
  • 15 Domains
R620 monthly

Business

  • 50 GB Disk Space
  • 50 Email Accounts
  • 50 GB Monthly Bandwidth
  • 10 Subdomains
  • 15 Domains
R630 monthly

Premium

  • 50 GB Disk Space
  • 50 Email Accounts
  • 50 GB Monthly Bandwidth
  • 10 Subdomains
  • 15 Domains

Latest news

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce vitae risus nec dui venenatis dignissim. Aenean vitae metus in augue pretium ultrices. Duis dictum eget dolor vel blandit.

SP Net Accreditation forms

June 28, 2018

When taking on risk in new payment models, you’ll be subjected to more compliance and regulations, and even delegation oversight. Learn from a health plan expert what to expect in taking risk and how to mitigate challenges with good planning and preparation by your management team.

PLEASE USE BLOCK CAPITAL ONLY. Application to be an accredited SP Net provider (to be completed by each Practitioner within a Practice)

Click to Download

SUMMARY OF RESULTS FROM THE HEALTHCARE CONSUMER SURVEY

Nov 18, 2016

Imperfect1 and asymmetric2 information in any market is seen as a major factor that weakens the ability of consumers to encourage competition that drives efficiency and quality. In most markets, information on quality and price are what allow consumers to make choices between providers. The question thus arises as to whether better-informed consumers/patients could lead to substantial improvements in health costs, quality and ultimately outcomes.

Click to Read more

SP Net June 2018 report to members

June 04, 2018

Colleagues: 2018 has come with its challenges. We are preparing for NHI and the changes that it will bring to the industry. As a network, we should be prepared for these changes. I will later draft a report on this issue and outline challenges that we will face and propose solutions regards how we should ready ourselves for this eventuality. Some of our providers have experienced a visit by the scheme forensic units and and have found themsleves in a precariuos situatio because of that.

Click to Read more

SP Net Brief Profile

February 28, 2011

The South African Medical and Dental Practitioners (SAMDP) is an organization representing medical providers countrywide, including doctors in the public and private sector, plus the army. It represents black doctors in the South African Medical Association (SAMA). It is a Section 21 company that has an association with SP Net.

Read more

Your news title here

June 28, 2018

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris quis ligula sapien. Ut auctor nibh vitae aliquet mattis. Proin consequat maximus commodo.

Read more

SPNET

SPNET members provide comprehensive healthcare through coordinated and accountable physician group practices. We strongly believe that patient-centered, coordinated, and accountable care offers the highest quality, most efficient delivery mechanism, and greatest value for patients.

Our Location

P O Box 2224, Roodepoort 1725

Call us on

011 494 1830
011 494 2326

Email address

exo@icon.co.za
info@spnx.co.za