2019/12/12 – CompCare Year End Provider communication
IMPORTANT COMPCARE WELLNESS MEDICAL SCHEME NOTIFICATION FOR 2020
With regards to the CompCare and Selfmed amalgamated Scheme (CompCare) please be advised of the following important operational information that will come into effect from 1 January 2020:
· As from 1 October 2019 onwards, all Selfmed options have been administered by Universal Healthcare and the process remains in place from 1 January 2020 onwards;
· It is important to note that some of the Selfmed options will merge into CompCare options and one new option will be created.
The new option layout is displayed below:
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Merging of CompCare Benefit Options
1 January 2020 onwards
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Changes to 2019 Options for 2020
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CompCare Benefit Options
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CompCare options for 2020:
– Pinnacle; and
Pinnacle Efficiency Discounted (ED) Option
– Dynamix; and
Dynamix Efficiency Discounted (ED) Option
– Symmetry; and
Symmetry Efficiency Discounted (ED) Option
– Selfsure
– Mumed; and
Mumed Efficiency Discounted (ED) Option
– UniSave
– MedX; and
MedX Efficiency Discounted (ED) Option
– NetworX; and
NetworX Efficiency Discounted (ED) Option
– SelfNET
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Please note the following:
· Please confirm with your patients which option they are on – some patients may have changed options to an option other than the option with which its merges;
· Please ensure that you do not use any Selfmed membership numbers or switching/clearing codes;
· The patients’ authorizations for chronic medication will be transferred to the new option in cases where the options merge;
· In certain instances where members elect to change their option, chronic formulary changes might require the member to reapply for chronic authorization; and
· A patient on MedX will have different benefits when compared to the MedXXI and Axis options – please ensure that the member does have cover for treatment planned.
Please refer to the below table for confirmation of the switching codes:
Claims switching / routing codes
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ADMINISTRATOR
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SCHEME
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PLAN NAME
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OPTION
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MEDIKREDIT
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DATAMAX CODE
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EDISERVECODE
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HEALTHBRIDGE CODE
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ITRACK CODE
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LENASIA CODE
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MEDISWITCH CODE
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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DYNAMIX
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DYNAMIX
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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90831
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MASSMART
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NETWORX
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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92198
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MEDELITE
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MEDELITE
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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93222
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MEDX
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ED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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93234
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MEDX
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MEDX
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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93227
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MUMED
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ED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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92457
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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MUMED
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MUMED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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90768
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL NETWORK
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COMPCARE UNIVERSAL
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NETWORX
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NETWORX
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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90960
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL NETWORK
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COMPCARE UNIVERSAL
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NETWORX ED
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NETWORX ED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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TBA
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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PINNACLE
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PINNACLE
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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90938
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL NETWORK
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COMPCARE UNIVERSAL
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PINNACLE ED
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PINNACLE ED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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TBA
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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SELFNET
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SELFNET
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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93217
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129P
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129P
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QEDI :129P, Destination : SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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SELFSURE
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SELFSURE
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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93221
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129P
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129P
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QEDI :129P, Destination: SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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SYMMETRY
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ED
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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92443
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129P
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129P
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QEDI :129P, Destination: SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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SYMMETRY
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SYMMETRY
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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90928
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129P
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129P
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QEDI :129P, Destination: SSCC0000
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UNIVERSAL HEALTHCARE
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COMPCARE WELLNESS
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UNISAVE
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UNISAVE
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Dispensing Dr (COMDD – 620699); Pharmacy (CCOMP – 620680)
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COMPCARE
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STATUS
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92561
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129P
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129P
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QEDI :129P, Destination: SSCC0000
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Contact Details
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CompCare Contact Details
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First Time Claims Submission:
Email: claims@universal.co.za
General/Claims Enquiries:
Tel: 0861 222 777
Email: compcare@universal.co.za
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Pre Authorisation and Hospital Admissions:
Tel: 0860 111 090
Oncology:
Tel: 0860 111 090
Email: oncology@universal.co.za
Case management:
Tel: 0860 111 090
Hospital accounts:
Tel: 0860 111 090
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Chronic Medicine Management:
Tel: 0860 111 900
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Yours sincerely,
The Universal Provider Team