Financial matters

The practice is contracted with most of the major medical aids and for clients with medical aid, claims are sent directly to the respective medical aid via Healthbridge, a cloud-based medical billing platform. Before engaging in therapy, it is the client’s responsibility to enquire from their medical aid what cover (if any) they have for psychological services. Please note that the client is liable for settling the account should the medical aid reject the claim or should there be a co-payment. It is the responsibility of the client to monitor the balance of their medical aid benefits and to inform the practice when one’s benefit is reaching exhaustion.

Medical aids require the ICD-10 diagnostic code on all invoices. Should a client wish for such a code not to appear on an invoice, this needs to be clearly stipulated in writing and one needs to understand that medical aids will not cover the uncoded service and that the client is liable to settle the invoice privately.

For private/ cash clients, an invoice will be emailed within a week of the appointment. This needs to be settled via EFT within 72 hours of receipt of invoice. Importantly, clients are asked to please make use of the invoice number as a reference when making payment. This needs to be the unique invoice number issued with each invoice (i.e.: please do not use the same reference for each payment so as to ensure the funds are correctly allocated to your account). Proof of payment is to be emailed to accounts@sampretorius.com.

Sessions are charged as per the medical aid rates stipulated for the year 2023 which vary slightly from medical aid to medical aid and range from R1135 to R1250 (please consult with your medical aid for your schemes' exact rate). Extended initial sessions (up to 80 minutes) range from R1387 to R1698, depending on the medical aid. In some instances, clients may be required to make a co-payment for extended sessions.

When a medical aid client’s benefit for psychological services has been exhausted, clients are responsible to settle the balance of the rejected claims.

Cash/ private clients are billed at the lowest end of the 2023 medical aid rate range (R1135) for a 50 minutes session and up to R1387 for the initial extended session.

EMDR sessions are often longer than the standard 50 minutes and are billed for accordingly. In some instances, medical aid clients may be required to make a co-payment for extended sessions.

Rates are subject to an annual increase in January of every year.

Non-payment of invoices will result in therapy being temporarily suspended until such time as the account is settled in full. A last resort for non-payment is the use of a debt collection service.

All accounts are processed by the practice’s Accounts Administrator, Lesley-Ann Andrews, who can be reached at accounts@sampretorius.com.