GENERAL TERMS AND CONDITIONS APPLICABLE TO PERSONS JOINING THIS PRACTICE AS PATIENTS PRIVACY INFORMATION
The personal and health information that is provided by you and recorded in your Electronic Health Record (Vericlaim) is collected to provide you with treatment. All the information provided by you is treated as strictly confidential by Dr Novikova and the practice staff. Should you belong to a medical aid scheme, the medical aid will forward such account to the principal member of the medical aid, confidentiality may be compromised as legislation compels this practice to provide certain information to the medical aid on the accounts. Failure to submit the correct codes might lead to the claim being incorrectly paid or not being paid at all. Regulation 5(f) of the Medical Schemes Act (published in the Government Gazette NO 20566 on October 20th, 1999) states that an account to the medical aid must contain the relevant diagnosis. This must be submitted as an ICD-10 diagnostic code (number allocated to your diagnosis by the international classification of diseases) and may be used in referral letters, requests for special investigations, prescriptions. During the procedures, photos and videos may be taken to be included in your health record as well as for educational purposes. There will be no identifying information attached to the video or photo data that will be published in scientific papers or presented at conferences.
COMMUNICATION FROM THIS PRACTICE
We strive to keep to environmentally conscious initiatives by minimising the use of paper. We will e-mail you your accounts, statements, receipts, quotations, authorisation forms. Dr Novikova will e-mail you all your results if they are normal. If the result is NOT normal we will call you to schedule an appointment to discuss the results.
If hospitalization is required, it remains your responsibility to ensure that the planned treatment is covered by your medical aid and that the necessary finances are arranged to cover non-insured costs. The medical aids generally do not cover aesthetic surgery. Medical aid may sometimes cover part of your treatment and you are responsible to cover the gap. The practice will provide you with all the necessary documentation to facilitate the authorisation process. Quotations for services are provided for submission with your authorisation documentation, in the case of elective procedures.
SETTLING OF ACCOUNTS
Our fees are based on an independent survey of practice costs within the industry and may be viewed on our website. Fees for consultation and procedures in the rooms are available on request. Office consultations and procedures are due and payable in full on the day of service. Procedures fees are paid two days before the procedure. Current payment options are credit/debit cards, cash and EFT. Telephonic consultations, repeat prescriptions, authorisations, motivations and medical reports (in the absence of face to face consultation) are billable services. We can provide you with a quotation for any required service.
Your information may be used by Dr Novikova to contact you for the results of your tests, for medical research to evaluate the service and/or medical treatment that you have received. Please circle YES or NO as appropriate below