MEDISCOR (PTY) LTD 1257 South Street, Centurion PO Box 8796, Centurion, 0046 Tel: (012) 674 8000 Fax: (012) 674 8001	NOTIFICATION 11 OF 2010
		Date: 29 June 2010

Medical Scheme	Day1 Health
Administrator	1 Doctor Health
Information Relevant to	New Mediscor Scheme
Effective Date	1 July 2010

With effect 1 July 2010, Mediscor has been exclusively contracted by Day1 Health to process all acute pharmacy claims. Day1 Health is not a medical Scheme but a Pre-Paid Preventative Health Care Service supplied by a chosen Network doctor to cover day to day medical expenses. Only acute medication, restricted to a medicine formulary may be dispensed by pharmacies. All Day 1 Health members are linked to Network doctors and the cover does not include specialist visits. Acute claims where the prescriber is a specialist will reject.

Detail to process pharmacy claims are outlined below:

Herewith the detail for submitting medicine claims to Mediscor:

1.	Scheme Code (PCN)	MDS0053
2.	Switch Destination Code	DHEA0004
3.	EDI Activation Code (Dispensing Doctors)	Not applicable
4.	Reference pricing (MRP®)	Yes
5.	Maximum supply of medicine	30 Days
6.	Days of supply of the dispensed medication	Yes /Compulsory
7.	Membership number as per membership card	Yes / Compulsory
8.	Dependant code as per membership card	Yes / Compulsory
9.	Dependant first name as per the membership card	Yes / Compulsory
10.	Dependant date of birth	Yes /Compulsory
11.	Dependant’s gender (male/female)	Yes / Compulsory
12.	Practice number of the prescriber	Yes / Compulsory
13.	ICD-10 diagnostic code	Yes / Compulsory
14.	9 digit NAPPI code of medicine dispensed	Yes / Compulsory
15.	Membership number requirements	Minimum 11 alpha- numerical including dependant code
16.	Payments to Providers	1 Doctor Health
17.	Chronic pre-authorisation Mediscor ChroniLine™	No
18.	Reimbursement structure – Pharmacies	SEP + R26/26%
19.	Scheduled 0 or Unscheduled	SEP + max mark-up of 31% (VAT Excl.)

· MEDISCOR REFERENCE PRICE (MRP®) – information available on www.mediscor.net

· MEDISCOR FORMULARIES – information available on www.mediscor.net

· ICD-10 CODES – information available on www.medicalschemes.com

IMPORTANT: The details below serve as a GUIDELINE ONLY. Due to the complexities of various Levy, Co-payment, Formulary and Exclusion criteria; SERVICE PROVIDERS MUST refer to our on-line responses to apply the correct rules.

Herewith the scheme rules for Day1 Health effective from 1 July 2010:

OPTIONS	BENEFITS APPLICABLE	LEVY	MRP® co-payment	EXCLUSIONS
Day1 Health	Acute	No levies applicable	Yes	Restricted to a acute formulary. Please refer to on-line response.

If you require any assistance, please contact:

Mediscor’s Share Call Centre Helpline

:

0860 113 238 or 0860 117 705

Kind regards.

JACK PEREL