Responsible Consumption of Healthcare
Dear Valued Intermediary,
Please take note of the below communication that will be sent to all qualifying Policyholders/Members and Dependants.
Faced with many challenges to ensure the appropriate consumption of healthcare, the private healthcare industry has been confronted with the impact of irregular claims being submitted by
healthcare service providers.
In our commitment to provide access to affordable, quality healthcare, Primecure Healthcare Management (Prime Cure) has decided to meet this challenge head on by implementing various systems
and mechanisms that will enable the enhanced management of this apparent business risk.
Primecure follows a non-discriminatory and zero-tolerance approach in the identification of questionable transactions by designating SellFlo Consulting as their duly appointed
representatives to facilitate all forensic interventions which includes Fraud, Waste and Abuse.
In this regard, a number of Prime Cure Designated Service Providers claims are suspended for payment pending an investigation to determine the validity of such claims. Policyholders/Members
are still able to visit these providers, however, there may be resistance from these providers to service Policyholders/Members until claims are paid.
To ensure a streamlined service without any disruptions in the management of healthcare, should this situation arise, Policyholders/Members can access the Provider Search on the link below
to find alternate Designated Service Providers within their area until further notice.