The Sunday News
Tinomuda Chakanyuka Sunday News Reporter
@irielyan
THE Association of Health Funders of Zimbabwe (AHFoZ) is engaging individual private medical doctors over the impasse between medical aid societies and health service providers, with some doctors said to have indicated that they will continue accepting medical aid after 1 July. Health service providers last week vowed not to accept any medical aid from 1 July as the stand-off between them and health insurance firms ensues.Zimbabwe Medical Association (Zima) claims to be owed more than $220 million in unpaid claims by Medical Aid Associations.
The two parties were scheduled to meet on 10 June to find a solution to the impasse but failed with AHFoZ accusing health service providers of cancelling the meeting without giving any explanation.
AHFoZ chief executive officer Mrs Shylet Sanyanga told Sunday News on Friday that her association was now courting individual doctors after efforts to engage their association were not yielding the intended results.
She also expressed doubt that the stance taken by Zima to reject medical aid represented the sentiments of all health service providers in the country.
“The meeting that was scheduled between AHFoZ and Zima for the 10th of June 2016 did not take place as Zima cancelled the meeting without offering any explanation or proposing a new date. AHFoZ has therefore been engaging individual doctors who have confirmed that they will continue accepting medical aid after 1 July 2016. It is not clear whether the announcement by Zima represents the constituency,” she said.
Mrs Sanyanga could, however, not say how many doctors were engaged by her association and have confirmed to continue accepting medical aid after the 1 July deadline.
The AHFoZ boss disputed claims that medical aid societies owed health service providers about $220 million spanning over three years.
She said the issue at the centre of the impasse was not about non-payment by medical aid associations but about shortfalls which emanate from the difference between what doctors claim and the fee that medical aid pays.
“Shortfalls can only be eliminated if the doctors’ charges and medical aid fees are the same. In order for medical aid societies to pay doctors in full to avoid shortfalls, there is need to increase the member contributions which is not possible in this environment,” she said.
Added Mrs Sanyanga: “The issue being raised by doctors is that they are being garnished by Zimra on amounts not paid by medical aid societies/shortfalls. This is because medical aid societies do not pay ‘shortfalled’ amounts. If the doctors charge the shortfalls in cash from the patient then tax from that income becomes due. Medical aid societies cannot be involved in such instances.”
She said some doctors who were not charging shortfalls from their patients confirmed that they were not owed anything and were being paid within the prescribed 60 days. AFHoZ members are expected to settle the doctors’ claim within 60 working days.
“It should be noted that some doctors charge according to the tariff and do not charge shortfalls from their patients. Some have confirmed that they have no complaints as they are being paid within 60 days,” said Mrs Sanyanga.
The AHFoZ boss added that her organisation met with officials from the Ministry of Health and Child Care on Friday to discuss the standoff with health service providers. Although she was not at liberty to divulge details of the meeting Mrs Sanyanga said the gathering went well with the health ministry promising to look into the matter.
“AHFoZ had a meeting with Ministry of Health today (Friday) which went on very well. The ministry assured us that they are looking into the issue with a view to resolving it soon,” she said. Sunday News also requested records of the health providers’ claims that AFHoZ members had paid but Mrs Sanyanga said the records were not yet ready.
“The claims paid records you requested have to be collected from the funders. This office is currently collecting figures for 2015, which funders submit after audit. It would assist if the doctors provide the details of the outstanding claims,” she said. Zima secretary-general Dr Shingi Bopoto could not be reached for comment.
Reiterating their stance last week, Zima said they would ensure that when patients visit doctors with or without medical aid, they will be stabilised before being referred to a public hospital. The impasse between the health funders and health service providers has sparked panic among members of the public who are on medical aid as the deadline set by doctors is fast approaching.
