Dear Family Practitioner
AECI Family Practitioner (FP) Network Scheme Rates for 2018
AECI Medical Aid Society would like to thank you for your services rendered to our members during 2017 and looks
forward to partnering with you in 2018. There will be a 5.7% increase in the AECI FP tariff rates as well as the below
changes with effect 1 January 2018. Please take note, to continue as a participating FP on the AECI Network it is
not required to sign the Agreement again.
FP Network Reimbursement Model:
The AECI FP Network reimbursement model for 2018 will continue to include an enhanced fee in accordance with
your REPI2 category score.
AECI FP Network consultation fee / R361.70
Enhanced consultation fee for REPI2 category 1 FP Network practices / R108.50
Enhanced consultation fee for REPI2 category 2 FP Network practices / R36.20
Please do not add the enhanced consultation fee to your AECI FP network consultation fee, as it will automatically
be assigned to qualifying practices upon payment of consultations. The participating rates are also available on
the Medscheme website on
Billing Process:
Your remittance advice will show a comment code 247 against each consultation qualifying for an enhanced fee.
The enhanced fee Rand amount will not reflect on each line. The sum total of your enhanced fees is shown as
one amount flagged with code 247 and the description "Enhanced fees" at the beginning of each Scheme's claim
line. For example:
50 (consultations) X R108.50 (enhanced fee) = R5,425.00
Coordination of Care (FP Nomination):
AECI supports care coordination and considers the Family Practitioner (FP) to be at the heart of this
process. Fragmented healthcare has resulted in inefficient, costly treatment for our members, therefore,
AECI believes that FP care coordination improves the quality of healthcare and lowers overall health
expenditure. AECI encourages their beneficiaries to nominate their treating Network doctor to coordinate
their care. This can be done by contacting the Healthcare Provider Call Centre on 0861 112 666.
Two visits per family per annum will be available from the 'out of nomination' benefit if a beneficiary needs to
see a FP other than their nominated FP.
Specialist Referral:
AECI recognises the family practitioner as our members' coordinator of care and therefore we request that
you continue to obtain an automated authorisation when referring your patient to a Specialist. This can be
done by contacting the Health Care Professional Contact Centre on 0861 112 666.
ICPS (Improved Clinical Pathway services) and JointCare, preferred provider for hip and knee replacements:
ICPS and JointCare are the preferred providers for AECI members. ICPS and JointCare are groups of orthopaedic
surgeons that specialise in performing hip and knee replacements according to standardised clinical care pathways.
These care pathways have been developed in accordance with evidence-based outcomes to ensure that the quality
of the hip and/or knee replacement is of the highest standard and to ensure the best health outcomes.
Call the Healthcare Provider Contact Centre on 0861 112 666 and you will be given the details of an ICPS or JointCare
orthopaedic surgeon closest to you.
If the decision for surgery is made by the orthopaedic surgeon, ICPS and JointCare will ensure payment in full
(subject to the prosthesis benefit) with no co-payment for the procedure which will include the following:
All hospital costs
Surgeons and anaesthetist fees
Prosthesis (subject to prosthesis benefit)
Physiotherapist (pre-, intra-and post-operative)
Continuation of Agreement:
You do not need to sign or return the Agreement. Should you wish to opt out of the Agreement, please inform AECI
in writing on or before Wednesday, 27 December 2017. This can be done via email to or
fax to 0860 222 453. Failing which, it shall be deemed that you agree to the contents hereof and are legally bound
thereto. You are also welcome to view the AECI annexure online by visiting (login in as a
provider and click on Networks > E- contracts).
If you have any questions, please call the Healthcare Provider Contact Centre on 0861 112 666.
Kind regards,
AECI FP Network Management