Call us directly: 0861 111 501

Licence: CMS BR5404 & FSP 19742

Authorised Financial Service Provider

CMAC Licence: FSP 17112  CMS: ORG 35

James Easton - Licence: CMS BR 39065

LIBERTY MEDICAL SCHEMES

Dear Marie
Liberty Medical Scheme introduces Pathology Packages of Care

Year on year, in-hospital pathology costs have escalated in an unsustainable manner.  Liberty Medical Scheme recognised a need to manage this experience and has since developed a clinical product called ‘Pathology Packages of Care’ to be implemented from November 2013.   The Pathology Packages of Care are groups of pathology tests relevant to a selection of elective surgical procedures.

The Packages were designed by clinical advisers based on best practice

The packages were designed by a panel of clinical advisers, including a pathologist, and are based on a comprehensive review of best practice in pathology testing. The result of this is packages that include all relevant pathology tests for selected uncomplicated elective procedures. Each customised package is designed to inform the doctor, member and hospital what tests will be routinely funded during your client’s hospital stay.

How it works: packages are pre-authorised but with flexibility to give patients quality of care

  1. Once a member’s elective surgical procedure is approved, Pathology Package/s of Care will be activated automatically and linked to the procedure for which your client is scheduled.
  2. We will send an authorisation letter to the doctor, your client and the relevant hospital, including a list of the tariff codes for the approved pathology tests to be conducted in-hospital and covered by Liberty Medical Scheme, subject to available benefits and limits.
  3. If your client requires additional tests, their doctor should contact us on 0860 002 163  or email us at approvals@libertyhealth.co.za to motivate for the tests in writing. Tests that are relevant to your client’s specific clinical circumstance will be added to their Package of Care.
  4. Pathology Packages of Care currently apply only to admissions for selected elective surgical procedures and not to emergency surgical procedures or medical admissions.   Surgical procedures are considered ‘elective’ when, although they are clinically necessary, are planned for a chosen date in the future.

You can contact us if you have any queries and we will gladly assist

If you have any queries regarding the above please contact our Call Centre on 0860 002 168 for more information.

Yours sincerely
Liberty Medical Scheme