Dear General Practitioner
NEW GENERAL PRACTITIONER (GP) TARIFFS FOR 2017
We wish to inform you that MMI Health (Pty) Ltd, of which Metropolitan Health Risk Management (MHRM) is a fellow subsidiary, is busy with consolidating its health businesses. Please see below the 2017 rates payable for the Medical Schemes listed which previously fell under Metropolitan Health Risk Management (MHRM).
MMI Health is an accredited managed care service provider that forms part of the health sector of MMI holdings. We are responsible for establishing and maintaining provider networks for medical schemes.
The MMI Health GP network is open to all willing GPs and some of the benefits of participating include:
  • An enhanced reimbursement rate for consultations.
  • Preferred provider status for services rendered to members of the named schemes.
  • Designated Service Provider (DSP) status for primary care Prescribed Minimum Benefits (PMB).
Transmed Medical Fund in respect of the Private Network Plan makes use of the MMI Health GP Network.
The following 2017 reimbursement rates apply:
Tariff item / Reimbursement model / Transmed Private Network Plan 2017
GP consultation: MMI Health Network / 103% of Scheme rate / R 344.90
GP consultation: MMI Health Non-network / Scheme rate / R 334.80
BP Medical Aid Society makes use of the MMI Health GP Network, and the following 2017 reimbursement rates apply:
Tariff item / Reimbursement model / BPMAS 2017
GP consultation: MMI Health network - IPA / 110% of Scheme rate / R 389.80
GP consultation: MMI Health network - non-IPA / 105% of Scheme rate / R 370.70
GP consultation: non-network / 80% of Scheme rate / R 283.10
The Budget Option of Imperial Group Medical Scheme makes use of the MMI Health GP Network and the 2017 rates below apply. Please note that payment is set up differently, and the member is required to pay a standardised co-payment as indicated in the following table:
Tariff item / Reimbursement model / Budget Option 2017 / Scheme payment to GP / Member payment to GP
GP consultation: MMI Health network - IPA / 110% of Scheme rate / R 379.60 / R 327.90 / R 51.70
GP consultation: MMI Health network - non-IPA / 105% of Scheme rate / R 362.40 / R 310.70 / R 51.70
GP consultation: non-network / Scheme rate / R 345.10 / R 293.40 / R 51.70
*IPA – Independent Practitioners’ Association Foundation of South Africa
Should you have any queries regarding the GP Network, please do not hesitate to contact the MMI Provider Engagement Team at , we will be glad to assist you.
May you have an enjoyable festive season and a restful holiday!
Yours faithfully
MMI Health Provider engagement Team