Sat, 19 Sep 2020

Gauteng health collects over R500m from RAF claims

15 Sep 2020, 04:11 GMT+10

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Mamabolo reflected on this progress in a meeting with Batsumi Claims Management Solution - the service provider tasked with assisting the department with the "complex nature" of administering, processing, and recovering claims from the RAF in respect of medical supplier claims.

"The process to collect from [the] RAF is quite involved. It requires visiting and analysing the accident scene, compiling official accident reports, and statements from witnesses in case of multiple accidents, amongst others.

"The department has no in-house skills to do such work," Mamabolo explained.

The GDOH submits a claim to the RAF to recover the costs incurred after it has treated a road accident victim.

According to the department, the collection service is based on risk and is commission-based.

"The GDOH only pays the service provider on an agreed commission rate which is only paid once the recoveries have been received by the GDOH and from that the company has been able to claim from RAF after meeting their stringent claims criteria," spokesperson Kwara Kekana added.

In addition, from the RAF claims over the past three financial years, Batsumi was paid 18% commission when accrual payments were excluded.

Therefore from the rounded-off figure of R523 million collected in revenue over the past three years, Batsumi was paid roughly R146 million.

"MEC Mamabolo pointed out that given the fact that Gauteng is South Africa's economic hub and it boasts some of the largest road networks in the continent, there is a high volume of cars on our roads traveling within the country and into other parts of the continent.

"This results in road accidents in which people require medical attention through the province's healthcare system," Kekana concluded.

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