Circular 7 of 2021: Revised Healthcare Utilisation Annual Statutory Return
The Council for Medical Schemes (CMS) hereby publishes the updated technical guideline document (Healthcare Utilisation Annual Statutory Return Technical Guideline for the preparation of data version 10.0) for completing the Utilisation section of the 2020/2021 Annual Statutory Return (ASR).
The implementation of the Medical Schemes Act (No. 131 of 1998) is closely monitored by the CMS to evaluate its impact on the industry and beneficiaries, and where necessary, to recommend legislative reforms. Submission of good, quality and credible data is essential to achieve this objective. By reviewing data specification documents, the CMS ensures that the latest developments and best practices are incorporated to collect good quality data.
The following updates and changes have been made in the technical guideline document:
| Part | Field | Amendment |
| B6 and B13 | · Discipline category | New field has been added to filter providers. |
| B14 | · Financial Month
· Discipline Code · Subdiscipline Code |
Additional fields included |
| B15 | · New Table | New part |
| All | · Year of Submission | “YearOfSubmission” changed to “YearOfSpec” |
| Updated CdRef Tables | ||
| ·CdRef 28 Discipline Category (New)
·CdRef 29 Tariff Code (New) |
||
This latest version of the technical guideline document should be read in conjunction with the following updated documents.
- ASR Data Specification v10.0: This workbook contains the layout and field type definitions for the data tables.
- ASR Valid Codes v10.0: The reference workbook containing tables with valid values for certain key columns specified in the ASR Data Specification v10.0
- Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 14.1 (The updated version of E&V will be published in February 2022).
Please provide us with your comments or inputs, if any, by 28 January 2022. You may send us an email at lion@medicalschemes.co.za, and officials from the CMS will be at hand to address all technical queries relating to the updated Healthcare Utilisation Data specification document.
Download the circular here.