1/13/2024 0 Comments Medihelp necesse chronic formulary![]() An emergency medical condition must be certified as such by a medical practitioner. An emergency medical condition means any sudden and unexpected onset of a health condition that requires immediate medical or surgical treatment, where failure to provide such treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place the person’s life in serious jeopardy. DTP is Diagnosis and Treatment Pairs which form part of the Prescibed Minimum Benefits. In certain cases (particularly for specialised dentistry), benefits are subject to approval by Denis. Medihelp’s dental benefits are managed by Denis and granted in accordance with Denis protocols, while Medihelp members obtain services from their regular dentists. The Medicine Price List (MPL) also applies to medicines in a formulary.Dental Information Systems (Denis) is South Africa’s leading dental benefit management company. If a formulary applies to the Chronic Disease Benefit on your option, we only cover the medicine that is listed on the formulary. This means if your doctor prescribes a new medicine for the condition, you may already be approved for it and can go straight to your pharmacy with your new script to collect your medicine.Ī formulary is an approved list of medicine for each of the chronic conditions covered by the Scheme. You’ll receive details of these treatment guidelines with your letter from Chronic Medicine Management (CMM). If you’ve applied for one of the 25 Prescribed Minimum Benefit chronic conditions, we’ve compiled treatment guidelines so that you’ll have access to appropriate treatment for your condition. Step 5: We’ll give you treatment guidelines This card records the medical condition for which we’ve approved treatment. If we approve your application for our Chronic Disease Benefit, we’ll give you a medicine access card. Step 4: You’ll get your medicine access card If we don’t approve your application, we’ll give you the reasons why, and you may ask us to review our decision. If we need more information, we’ll let you, your doctor or your pharmacist know exactly what is missing. Step 3: We’ll give you a response straight away They can either apply online or call our Provider Call Centre on 0860 100 220. Ask your doctor or pharmacist to apply on your behalf. ![]() Select the person who’s applying, click the “Chronic Authorisation” button at the bottom of the page and then select “New Chronic Application”. Once you’ve registered, click on “My Authorisations” and then select “My Chronic Application”. Apply here at You’ll need to register before you can apply.Call Chronic Medicine Management (CMM) on 0860 002 153 between 8.30am and 5pm on Monday to Thursday, and between 9am and 5pm on Fridays.You can apply for the Chronic Disease Benefit in the following ways: If you need any help gathering this information, please contact us on 0860 002 153. Total Cholesterol, LDL, HDL, glucose tests, thyroid (depending on your condition). Your prescribing doctor’s practice number.To get coverage for your chronic disease treatment, you or your doctor/pharmacist will need to apply for our Chronic Disease Benefit. To download comprehensive information about the chronic disease on your option click here If you’ve been diagnosed with a chronic condition (a disease lasting more than three months for which you’ll need ongoing treatment), we’ll cover your treatment as long as it falls on our chronic disease list.
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