Click here for a call back!
LET US CALL YOU BACK
Get a Quote Today!
Please wait...

WHY DO WE MAKE COURTESY CALLS TO OUR CLIENTS ?

Courtesy calling is a nice way to remind customers of upcoming appointments, check on the arrival of a replacement product or verify that a payment was received. However, it is important that the courtesy call be made the correct way. Customers don’t like receiving  sales calls, especially if they already do business with the company but a courtesy call is acceptable. This is a very important business key to build good relationships by adding this helpful service to your customer care procedures.Courtesy calling by Careline Group

We at Care Line Group always make sure that we provide our clients with the best quality of service.  When making a courtesy call to our members we make sure of the following :

  • Courtesy call is coming from a company phone
  • There is a good signal and the call is of good quality
  • We wait for the client to answer, then we introduce ourselves and the reason for call
  • We strive to be polite and help full at all times
  • We keep our call short and meaning full
  • Lastly we thank the customer for their time and remind them that we are there to assist should they need any assistance with their inquiries

Questions we ask our clients :

  • Are you on a medical aid, happy with their service and the product ?
  • Are your personal details still the same, if not we update our system ?
  • For example addresses, email addresses, cell number.
  • We inform the client about life, short term insurance, funeral cover ext and if they are interested we can arrange for a quote from a professional adviser, who will be calling them.
  • We also ask them for referrals of family and friends that might be interested in life or health.

By doing these calls we keep a professional relationship with our clients and in future they know who to deal with when it comes to medical or life inquiries.

CareLine Group will take the time to assist you read more about our Service Medical Aid Assist programs, click here.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

Short Term Insurance

The purpose of short term insurance is to assist you, should you be in an accident or for the loss of damage to your vehicle or goods. You can get cover for your building (house), household contents, all risk items and vehicles.Short Term Insurance let Care Line Group in Alberton get you coverd

Here are hand tips that Care Line Group wants to point out to you when choosing a Short Term Insurance.

  • When insuring your building, confirm with your broker that all fixtures are covered, for an example, pool pump, geyser etc.
  • You need to provide your broker with all means of security taken to protect your property, for an example burglar bars, security gates, alarms linked to security companies,  etc.
  • When insuring your household contents, you should make sure that you are not under insured.  Take in consideration that should there be a fire you will have to replace clothing, bedding, curtains, furniture, etc.
  • It is suggested to keep proof when purchasing new items.
  • All risk means all items that can be taken away from your property, for an example cell phones, laptops, spectacles, expensive sport equipment, etc.  Serial numbers as well as values of these items must be provided.
  • When insuring your vehicle, you must provide year, model, value, colour, security features, and all extras.
  • Remember to provide details of immobilizer, alarms, trackers etc, as this can affect your monthly premium.
  • All extras includes radio and accessories, mags, canopies, etc.
  • When using a bakkie for company purposes, you can also get cover for tools or equipment in transit.
  • It is important to confirm that both your building and vehicle are covered against hail damage.
  • When you are applying for a quote, your claims history for the past five years will be a requirement.  Therefore make sure that you are providing your broker with the correct information, as non declaration of previous claims will result in new claims being rejected.

Care Line Group is an authorized financial service provider, give us a call on 0861 45 00 45 to get a free comprehensive quote on your Short Term Insurance Today.

Click Here to read more on Short Term Insurance and here to get tips on how to save on your monthly Premium for your Short Term Insurance.

Continue reading...

CompCare is Rated No. 1

Compcare Rated No 1

Die Beeld and www.Netwerk24.com covered the survey with the headline, “Mediese fondse: Discovery grootste, nie die gesondste”, which highlights the fact that although Discovery is the biggest they are not necessarily the healthiest.

Healthcare consultants, Grant Thornton Capital (GTC) believes that one of the most important issues to consider when a medical scheme option or plan is being proposed to a client is affordability. We at Universal Healthcare and CompCare Wellness Medical Scheme support this approach and appropriately blend our member value proposition by including factors of affordability, suitable benefits and a personal approach where we put the member at the centre of all we do.

The GTC Medical Aid Survey focusses attention firstly on the plan type being considered and secondly on the premium, with an overlay of the CMS Annual Report on scheme demographics. GTC included the following in assessing the country’s open medical schemes:

  1. Risk and complete annual costs per family size for the comprehensive plan range;
  2. Risk annual costs per family size for the balance of the plan ranges;
  3. Coupled with their required cover level, in and out of hospital (Core/Saver/Comprehensive);
  4. The need to have a Gap Cover policy;
  5. Overlaid by the results as depicted in the CMS Annual Report, to reflect an overall rating per plan type.

Other factors that was taken into account in their assessment of the schemes included whether there was growth in total main membership, changes in the pensioner ratio of the scheme, the relationship between reserves and premiums, and whether there were any changes in the age profile of dependents. On these grounds they allocated a percentage of how healthy each scheme is, and CompCare scored an amazing 100%!

The CompCare Wellness Medical Scheme was identified as the healthiest of all open medical schemes and therefore the most likely to be recommended by healthcare consultants!

The graph below depicts the ranking as scored by GTC in relation to the most sustainable medical schemes in the country:
Compcare Medical Aid Scheme Rated No 1

Continue reading...

Authorizations

The follow information is requires to get an authorization number from your medical aid.Authorizations

  • The ICD 10 codes for the procedure you are going for.
  • The procedure codes for everything the Dr needs to do.
  • Date of the procedure / treatment.
  • The Dr and Hospitals practice numbers.

When getting the authorization number from your medical aid it is also very important to asked if they cover the whole procedure or treatment that members are going for so you are aware if there will be co-payments or not.

Member needs to call the medical aid at least 48hours before the day of procedure or treatment so the medical aid can have enough time to process the necessary information so if they require more information there is still time to get the required information and process it.

All members must also be aware if you are in your first years of joining the medical aid the medical aids always have to do an investigation to see if it was not a non disclosed condition, then they will need more information from the member Doctor or Specialist regarding the procedure before they can authorize the procedure or treatment.

CareLine Group will take the time to assist you in Authorizations on our Medical Aid Assist programs, click here to read more.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

What to do when you have lost your medical aid cards

You can simply phone your medical aid scheme at their call center and request for them to post you a new set of medical aid cards. Or you can call Care Line on 0861 45 00 45 and we will happily assist you.  You are allowed to order up to three  cards for your family.  The agent from the call center will confirm your physical or postal address for where cards must be delivered.What to do when you have lost your medical aid cards

What to do in the meantime while an emergency occurs and you have to make use of a doctor, hospital or get medication.  You can ask the call center to email or fax you your membership certificate as proof of your membership.  This is a legal document and you only have to show it to the pharmacy or doctor’s rooms.  You can also log into your medical scheme’s website and obtain the document immediately.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

Do you know the difference between your MSA ( Medical Savings Account ) and your self-payment gap ( SPG)

Your MSA, medical savings account is there for all of your medical expenses out of hospital for example, x-rays, claiming of medication and payment of doctor’s and specialists accounts. Do you know the difference between your MSA ( Medical Savings Account ) and your self-payment gap ( SPG)

The Self-payment gap is only a temporary gap in cover when you run out of funds in your Medical Savins Account and you have not reached your annual threshold.  When you reached your self-payment gap ( which means your msa are exhausted ) you are liable for the settlement of all accounts and paying of medication until you reached the limit of your selfpayment gap.  All receipts and detailed accounts in this period must be submitted to your medical aid as proof that you paid out of your own pocket and to fill this gap.  When this gap is filled up the scheme is going to start paying from your above threshold benefit.

The Above Threshold Benefit is like a safety net for all day to day claims that you submit to the scheme.  Some specific conditions and treatments do have limits.

CareLine Group will take the time to assist you with your medical savings account     with our medical aid assist program, click here to read more.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

Home care and the benefits of using home care

What is home care?Home care and the benefits of using home care

Home care offers you quality home-based aftercare services in the comfort of your own home.  Making use of these services, members receives care from a qualified caregiver and will be continuing living in their familiar surroundings of their homes, despite their condition.

This is an accredited service provide that gives high-quality service to members provided by professional nurses and qualified caregivers, who received additional training.

Home care can be used for the following reasons:

  • End of life care
  • IV drips or infusions
  • Wound care
  • Postnatal care

These treatments will be covered from your day to day benefits or compassionate care benefit.  Some treatments will be covered from hospitalisation.

How to apply for these services?

  • Discuss with your treating doctor.
  • Doctor must provide a motivational letter – which must be submitted to your medical scheme to the medical advisor to investigate.

What is the benefit of these type of services?

  • Patients don’t have to travel to a facility to receive these type of treatments.
  • You get an accredited nurse or caregiver to take care of you in your home.
  • Prevention of hospitalisations and shortening of days in hospital.
  • Some treatment can be rendered in your home without being admitted into hospital.

CareLine Group will take the time to assist any member to find a Medical Aid that will suite your needs.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

WHO MAY BE REGISTERED AS A DEPENDANT?

All dependants may be registered onto a medical aid from which a new member is enrolled or from a later date.How many people do you want to join on the Medical Aid?

A child who is not self supporting and who is a dependent on his family for care and financial support.

Examples of dependants:

  • Spouse / partner
  • Father / mother
  • Brother / sister
  • Grandchildren
  • Newborn of a member

Other children:  ( Legal documentation must be submitted with the registration of the following children ).

  • A grandchild adopted by grandparents as a foster child in safe care
  • Stepchildren
  • Adopting of a child, being placed in foster care
  • Foster child
  • Child temporary in safe care

WHO MAY NOT BE REGISTERED AS A DEPENDANT?

  • Godchildren
  • In-laws
  • Step grandchildren
  • Step parents
  • Stepbrothers and stepsisters who are not children of the member
  • Children under guardianship

THE REGISTRATION PROCESS

There is certain forms to be completed to get the process in place:

  • Registration of child dependant
  • Registration of dependant
  • Registration of new-born baby
  • Birth certificates or a copy of id document must accompany these forms
  • Marriage certificates ( on request only )

These documentation must be submitted to the medical schemes for processing.

WAITING PERIODS AND LATE JOINER PENALTIES

In case of a new-born baby, during an existing membership, no waiting periods will apply.

But with other cases with the registration of children the following may apply:

  • 3 Month general waiting period
  • 12 Month condition specific waiting period
  • Remainder of any waiting periods will be applied by the next medical scheme

CareLine Group will take the time to assist you in adding a new dependent on your Medical Aid.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

Waiting periods on joining Medical Aid Schemes

If a member cancel their medical aid membership the member get 90 days to do a new application before the come a new applicant that can get a 3 months general waiting period and a 12 months conditions specific waiting period.waiting period on Medical Aids

If a member is a new applicant they can also receive a 3 months general waiting period and a 12 months conditions specific waiting period (a new applicant is called an A client). If a member is and B client a member can only receive a 12 months condition specific waiting period and a member get PMB cover (PMB: Prescribed minimum benefits), a member will only get a B clients underwirtting if member was on a medical aid up to 2years and that does a new application before the 90 days is over.

If a member is a C client a member can only receive a 3 months general waiting period and member will also ger PBM cover (PMB: Prescribed minimum benefits), a member will only receive a C clients underwritting when member was on a medical aid for more then 2 years.

CareLine Group will take the time to assist any new joiners to Medical Aid or current Medical Aid client in looking if waiting periods may apply to you.

Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

THE MEANING OF NON DISCLOSURE INVESTIGATION

What happens with a non disclosure investigation and when does it happen?THE MEANING OF NON DISCLOSURE INVESTIGATION

This happens when a new member is being admitted into hospital, and the hospital needs to get an authorisation number.

The meaning of a non disclosure investigation from all medical aid schemes,  is that when a member joined a new medical aid and have been on the medical aid for less than a year and get admitted into hospital, the medical aid have the right to do a non disclosure investigation on that patient.

This means that if that member, who has been admitted into hospital, didn’t disclose the condition being admitted for on the medical aid application, the medical advisors from the scheme will do an investigation.  This is mostly for existing conditions, for example, diabetes, high blood pressure or hyperlipidaemia.

The doctors from the medical scheme will fax a non disclosure form to the patient’s doctor, requesting a year’s clinical history regarding treatment received for that specific condition (that the member has been admitted for).

The information must be provided to the scheme in the next 24 -48 hours to be processed and finalised.  If it is found that the patient did received treatment in the last year for that specific condition he has been admitted for,  and didn’t mentioned it on the application  the scheme has the right to terminate that whole new application.  The scheme can also  impose a 12 month specific condition waiting period or an exclusion.

The application may be terminated immediately and the member will have to re-apply again.

This will be the members decision to join the same medical aid scheme again or a different medical scheme.

CareLine Group will take the time to assist any new joiners to Medical Aid Schemes. Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

PROCESSING OF YOU NEW MEDICAL AID APPLICATION FORM – HOW DOES THE PROCESS WORK

Sometimes when you want to join a medical aid its sounds very complicated, but it’s not.NEW MEDICAL AID APPLICATION FORM

A medical aid advisor will make an appointment to go out and see you.  They will give you three comparisons between three different medical aids according to your financial and benefit needs.  It is very important as a potential client to inform your advisor of all treatment and procedures that you or your family members had in the past five years or planned to have in the next year.

The medical advisor will explaine to you by means of a needs analysis what the difference is between a hospital plan and a full medical aid plan.  You as the client can provide them with a figure more or less what you can afford and are willing to pay for a medical aid.  It is very important for a client to understand what the advisor is explaining to you according to the needs analysis. The advisor will explaine to the client about the 3 months general waiting period, the 12 months specific condition waiting period, PMB cover and if the member is going to qualify for late joine penalities ( ljps ).

When you complete the medical aid application form, the medical aid is going to ask you a few questions for example:

  • Personal details ( Initials and surname of main member, full id number, the joining date, residential and postal address ext. ).
  • Dependants ( Names and surnames, full id numbers and relationship to the main member ).
  • Previous cover ( Names of the medical schemes you and your family were on, membership number, date joined and date resigned from scheme ).  The scheme that you are joining will request proof of membership by means of all your previous membership certificates.  In some cases its very difficult to obtain a membership certificate – the scheme will allow an affidavit then, certified, stamped and signed by your nearest police commissioner ( station ).

Documentation joining your medical aid application?

  •  If you choose an income base option, you will have to provide 3 months payslips or 3 months bankstatements, depending on the main member’s  income or the person who will be paying for the medical aid.
  • Copy of the main member’s id document.

The application will take 5 – 7 working days, some schemes even longer,  up to 14 working days to be processed and finalised.

Your application form is going to a medical advisor ( doctor ) at the medical scheme who is responsible for processing and finalising your application.

Should you have any existing conditions the client will receive a letter of acceptance of the conditions with a waiting period, to sign and return to the scheme for processing. As soon as the scheme receives this letter it will be finalised and the member will receive his or her medical aid number and membership  certificate.

In some cased there are applicants who hands in a clean application with no conditions and they will receive their member number and membership certificate immediately.

CareLine Group will take the time to assist any new joiners to Medical Aid or current Medical Aid client in looking if waiting periods may apply to you. Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...

Getting your claim paid as PMB

What is the meaning of PMB?GETTING YOUR CLAIM PAID AS PMB

Prescribed Minimum Benefits.
This means  there are certain life treating conditions that your medical aid needs to pay for  as a PMB condition.

What is the meaning of life threatening conditions and what conditions are they ?

Life threatening conditions means you as the patient or your family member or friend needs immediate treatment or that person could die. 

Examples of life threatening conditions are:

MVA ( Motor Vehicle Accident )

  • Diabetes
  • Asthma
  • Stroke
  • Epilepsy

These are only a few examples of PMB conditions.

What do you need to do to get a claim paid as a PMB condition?

  • Firstly you need to qualify for PMB cover.  This means you will be a category B or C client.
  • You need a detailed account from your doctor or hospital.
  • Your claim will be submitted as a normal claim for payment to your medical aid.
  • Should there be a short payment on the account, find out what category client you are and if you do qualify for PMB cover.
  • If you do qualify and your claim was short paid, confirm this from your medical aid.
  • The medical aid will confirm if the case do qualify as a PMB or not.
CareLine Group is here to assist you in looking at many different medical aids. Seeing what medical aid would suite you best.
Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.
Continue reading...

Waiting periods on Medical Aids

Because of the new year and many new clients join Medical Aids or even just move over to diffrent Medical Aid schemes. It is important to understand how Medical Aids handle underwriting on waiting periods.CareLine Group can assist you with your Waiting periods on Medical Aids

Here are a few underwriting basics:

First of all as soon as a client decides to take out a new medical aid or move from their current medical aid over to a new one, CareLine Group need all previous medical aid cover to insure the client gets the correct underwriting.

CareLine Group will submit the cover with the application and the underwriters will process it and make a decision. They will look at how many years you belonged to a scheme and work according to that.

There are 3 types of clients:

“A” client is a new applicant with a break from a scheme more than 90 days. A clients will receive a 3 month general waiting period, 12 month condition specific waiting periods on all conditions treated for a year back from date of application. “A” clients unfortunately does not have PMB (prescribed minimum benefits) cover.

“B” clients are members who have belonged to a medical aid for 0-24 months without a break longer than 90 days. “B” clients will not get a 3 month general waiting period but will receive 12 month condition specific waiting periods for all current conditions. PMB cover will be given to a “B” client.

“C” clients are members that have belonged to a medical aid longer than 24 months without a break longer than 90 days. “C” clients will receive a 3 month general waiting period but no 12 month condition specific waiting periods. PMB cover will be given for a “C” client.

The reason these waiting periods were implemented are to protect the funds of the Medical Aid Scheme.

CareLine Group will take the time to assist any new joiners to Medical Aid or current Medical Aid client in looking if waiting periods may apply to you. Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.

Continue reading...