I/We declare that the details on this Banking Verification form are correct and may be used by Kaelo Prime Cure for the reimbursement of valid claims. I/We authorise Kaelo Prime Cure to pay any amounts which accrue to the stated practice to the credit of the stated provider’s account into the mentioned bank account.

2.1 I, the aforementioned and undersigned participating provider, contract with Kaelo Prime Cure to service the aforementioned benefit options of Kaelo Prime Cure Healthcare, under the terms, conditions and provisions set out in this Agreement.
2.2 Kaelo Prime Cure wishes to establish a network of nurses and midwives to provide primary healthcare services to the beneficiaries of all medical schemes and insurance plan options and contracts the aforementioned and undersigned provider, to provide such services according to the terms and conditions of this Agreement.

Click to view a comprehensive list of medical schemes and insurance options : https://www.primecure.co.za/schemes-and-administrators/

3.1 “Beneficiaries” means the principal member or dependent as defined in the Act, who have subscribed to the aforementioned
benefit options of Kaelo Prime Cure and have to receive their primary healthcare services at a participating provider.
3.2 “Confidential information” means all information, methods and processes used regarding the business of either party, including without limitation, patents, patent applications, trademarks, trade secrets, designs, copyrights, specifications and know-how and/or financial information and methods, including information regarding patients records acquired either directly or indirectly by either party or any other party or person.
3.3 “Personal Information” means information relating to an identifiable, living, natural person, and where it applies to an identifiable, existing juristic person, including, but not limited to –
(a). information relating to the race, gender, pregnancy, marital status, national, ethnic or social origin, sexual orientation, age, physical or mental health, well-being, disability, religion, conscience, belief, culture, language and birth of the person;
(b). information relating to the education or the medical, financial, criminal or employment history of the person;
(c). any identifying number, symbol, email address, physical address, telephone number, location information, online identifier or other particular assignment to the person;
(d). the biometric information of the person;
(e). the personal opinions, views or preferences of the person;
(f). correspondence sent by the person that is implicitly or explicitly of a private or confidential nature or further correspondence that would reveal the contents of the original correspondence;
(g). the views or opinions of another individual about the person; and
(h). the name of the person if it appears with other personal information relating to the person or if the disclosure of the name itself would reveal information about the person;
3.4 “Effective date” means the date on which a contract takes effect or becomes operative and enforceable;
3.5 “Benefit exclusions” means the services not stipulated in Section 4 of Kaelo Prime Cure’s Rules;
3.6 “Month” means a calendar month commencing on the first day and ending on the last day of such month;
3.7 “Participating provider” means any nurse or midwife who is ready, willing and able or any general practitioner who has entered into and remains a party to an agreement with the Scheme, to provide primary healthcare services to beneficiaries.
3.8 “Payment Hold” means that payments to be made in good faith for services rendered will be put on hold during the period of an investigation/forensic audit which has no predetermined length of time in days.

4.1 This Agreement will become effective in relation to the parties from signature date and will remain in force indefinitely subject to the provisions of Clause 3. If you are an existing provider, the terms and conditions of this Agreement will replace any previous agreement between the parties and will apply in respect of any existing and new claims submitted to Prime Cure.
4.2 The parties agree that either parties may terminate this Agreement at any time within 30 (thirty) days of written and signed notice to the other parties, failing which this Agreement will continue in force indefinitely, but with the following provisos:
4.2.1 That the provider’s participation in the Agreement may be summarily terminated if at the discretion of Kaelo Prime Cure, it is impossible for the provider to provide unfettered services to the beneficiaries of the aforementioned benefit options.
4.2.2 That from time to time, changes to this Agreement may become necessary, including but not limited to the annual determination of fees for the following year and that the provider will be informed by Kaelo Prime Cure of such changes and the deadline, by which the Scheme must receive notice of termination, should the provider wish to terminate the contract as a result of the proposed changes, failing which the provider will be deemed to have elected to accept the changes and continue with this Agreement.
4.2.3 That this Agreement may be terminated/suspended with immediate effect by Kaelo Prime Cure if –
• The provider is convicted of any crime; or
• The provider is found guilty by the SANC and/or paid an admission of guilt fine to the SANC in relation to irregularities with billing or accounts rendered to Kaelo Prime Cure or its beneficiaries; or
• An investigation was concluded by the Kaelo Prime Cure forensic auditors and prima facie evidence of a white collar crime was obtained; or
• The provider abuses coding (including but not limited to up-coding, unbundling and optimisation). Kaelo Prime Cure ascribes to the South African Medical Association Medical Doctors' Coding Manual (MDCM).
4.2.4 The provider does not conform/comply with the points mentioned in Section C.

5.1 The rights and responsibilities of the parties are set out in the various Annexures to this Agreement.

6.1 The participating provider bears the responsibility to ensure that the correct and latest banking details are registered with Kaelo at all times.

7.1 This Agreement may be signed by the parties in counterparts, whether by way of facsimile or otherwise, and each signed copy will be deemed to be an original.

8.1 No agreement to vary any of the provisions of this Agreement or to cancel it will be effective unless made in writing and signed by the parties.