Telehealth codes for 2020 are expected to become compulsory for all businesses, starting from January 1.
This will also include the insurance companies, where the code will cover the whole population, as well as other companies that are part of the healthcare sector.
However, as a new market is expected to emerge, it is unclear how much the industry will have to pay up to, if any, the code’s initial price tag of R30bn ($US31bn).
The codes are set to come into effect for all the major operators within 2020, with some of the more notable providers expected to be able to introduce them.
They are set in three parts: one covering the public, another covering private businesses and another covering health professionals.
Here’s a guide to the 2020 telehealth code.
Who will be covered?
As of March, the codes cover all telehealth providers in the country.
The code will apply to the following sectors: Public health, medical and dental services, primary healthcare and specialist services, private hospitals, hospitals, general practitioners and dentists, pharmacy services, emergency medical services, nursing homes and health centres.
There are also some sectors where the codes will apply differently, such as public transport and leisure and hospitality.
What is covered?
For all health services covered by the code, the regulator will decide whether the service should be covered by a different code, or if there are any special codes.
For example, for health services provided by health professionals or services that are provided to the elderly, the health authority will determine whether the services are covered by codes for that category.
For those services that involve physical or mental health care, the relevant health authority may decide to provide a different codes for the services.
However the codes are expected for the majority of services, with only a few services having to be exempted.
The codes will cover all health professionals, private health services, general practices and dentistry, public transport, leisure and tourism and healthcare facilities.
They also cover other providers who provide services in the health sector, such a dentists and surgeons.
What are the exemptions?
The codes apply to services provided to any person or organisation regardless of the type of service they provide.
Examples of services which will not be covered include: primary health care services, such in-person consultations, appointments and tests; and medical services such as pathology and pathology imaging.
This excludes: prescriptions for drugs and devices, such medicines, isotopes, devices, diagnostics and diagnostic procedures; and prescription or other medical supplies, such laboratory supplies and equipment.
However some of these services are also covered by health authorities.
Examples include maternity and newborn care, dental services for children, urgent care and nursing home services, dental supplies and supplies for dental work.
The other services, for example care for children or nursing home residents, are exempt if they are provided by a health authority or a private provider that is licensed under the health codes.
There is a risk of some providers being excluded.
For instance, the insurance company AED will have an exemption for a range of services provided through their insurance company to individuals and their families.
However if their health insurance covers a group of services to a particular individual, such that the insurance is not covering that individual for those services, the insurer will be able not to offer the services in their insurance policy.
So how will it work?
The first part of 2020 is expected the telehealth operators will need to offer a special code for the sector, to avoid having to provide code for other health services.
The regulator will set a minimum threshold that all teleHealth providers have to meet, which can be higher or lower depending on the sector.
This minimum threshold will be applied to the teleHealth provider in each sector.
The final step will be the operator to establish a code for that sector.
In the case of health services where the operator does not have a code, there will be a second step.
This step will depend on whether the health authorities in the sector allow for code exemption for that health service.
If they do not allow for exemption, the operator will have a choice between two options: it can either decide to offer code exemption or the operator may continue to provide codes for all other health care and health services in that sector, with the exception of services in which the health insurance provider’s code is not covered.
In either case, the teleMedical provider will have the option of providing code exemption, with a risk that some providers will not accept code exemption.
What’s next for the codes?
TeleHealth codes are currently only for a limited period of time, and as a result the code may be rolled out over the coming months.
For the full telehealth services, including codes for other areas, the telcos will have until March 31, 2020 to start offering codes for consumers and businesses, or the regulator can issue new codes.
The first code will be for public health services covering the general public.
The second code will