Designated Service Provider (DSP)
These are the only service providers that members may use for certain services. If these providers are not used, Remedi may refuse benefits, apply co-payments or the member may have to pay penalties.
Members are exempt from any co-payment and/or levy in circumstances where they have involuntarily obtained a service from a provider other than a DSP, if:
- It is an emergency, for hospital admissions
- The service was not available from the DSP or would not have been provided without unreasonable delay; or
- There was no DSP within a reasonable distance from your place of business or residence.
Remedi’s DSPs for the diagnosis, treatment and care costs (which may include medicine) for Prescribed Minimum Benefit (PMB) conditions are:
- Medi-Clinic Hospital Group
- the state/public health system (all related services)
- CareCross Health (for Insured Out-of-Hospital benefits on the Standard option)
- Clicks Pharmacies (chronic medicines only)
- DisChem Pharmacies (chronic medicines only)
- Specialists practicing and/or operating within the Medi-Clinic Group of hospitals who charge fees of not more than the Reference Price List (RPL) for members on the Standard option or two times the RPL for members on the Comprehensive and Classic options; and
- Other service providers, as selected by the Scheme from time to time.
It is likely that Remedi will from time to time contract with and appoint more DSPs, particularly provider networks, in its ongoing efforts to control and reduce costs for members.
Here is a list of Remedi’s designated service providers for the diagnosis, treatment and care costs (which may include medicine) for Prescribed Minimum Benefits conditions:
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Benefit Option |
Remedi |
Remedi |
Remedi |
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SANCA and RAMOT, for drug and alcohol rehabilitation |
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The Discovery GP Network |
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The CareCross GP Network |
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The Classic Direct Specialist Direct Payment Arrangement |
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The Premier A and B Specialist Direct Payment Arrangements |
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The KeyCare Specialist Direct Payment Arrangement |
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|
|
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Pharmacies dispensing at Remedi Medicine Rates |
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CareCross contracted pharmacies |
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PPN |
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Mediclinic International |
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Department of Health – Western Cape |
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Remedi is always on the lookout for healthcare providers who can give our members quality care at affordable rates. We will add more designated service providers and networks to this list as they become available.
Limits, clinical guidelines and policies apply to some healthcare services and procedures. Please check the Benefit Option tables with benefits and limits in this brochure for more information.