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Circular 70 of 2022: Revised Healthcare Utilisation Annual Statutory Return

The Council for Medical Schemes (CMS) hereby publishes the draft technical guideline document (Healthcare Utilisation Annual Statutory Return Technical Guideline for the preparation of data Version 11.0) for comments and inputs. 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
A3 FormerSchemeRefno Additional field included
B1, B2, B3 and B11 Financial Month Additional field included
Updated CdRef Tables
·        CdRef 30 Scheme Refno (New)

·        CdRef 8 Discipline Codes (Added code 121=Covid Vaccine Sites)

This latest version of the technical guideline document should be read in conjunction with the following updated documents.

Please provide us with your comments or inputs, if any, by 27 January 2023. 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.

If you would like to make any comments or suggestions on Guidelines for the Identification of Beneficiaries with Risk Factors in accordance with the Entry and Verification Criteria Version, please submit your inputs to c.cairncross@medicalschemes.co.za.

Your cooperation will be highly appreciated.

Download the Circular here.