Road Accident Fund, private ambulances at loggerheads over payment
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Pretoria - The private ambulance sector says the Road Accident Fund (RAF) owes it millions, resulting in them refusing to attend to accident scenes where they were not assured of being paid directly by the patients or their medical aids.
This has left patients without medical aids and undocumented people out in the cold.
Dr Bongani Hleza, the owner of a private ambulance company, said they had tried to engage RAF chief executive Collins Letsoalo on many occasions about the situation, to no avail.
According to Hleza, directives issued by the RAF earlier this year required private ambulance services to obtain full particulars of the patient and accident reports before they could submit their claims.
Hleza said this red tape made it impossible for them to do their work, as they rendered a medical service to the patient and were not lawyers.
Hleza said the directive was the same as that which was issued to lawyers earlier in terms of which they were not allowed to lodge accident claims with the RAF unless they had the full list of documents at hand. The list was compiled by the RAF.
The high court earlier stopped the RAF from implementing the directive, as it did not comply with the RAF Act.
Hleza now questioned why they were still being held ransom by the directive. He said as things now stood, the private ambulance industry, when called to a scene, simply stabilised patients, as per their duty.
However, they did not transport patients to hospital if they did not have an ID with them or if it appeared that they had no means of paying.
“We wait for the police to arrive on the scene and for the government operating ambulances to take over the scene.”
Hleza said especially if the victims were foreign nationals without papers, the ambulance services did not even attempt to assist, other than to stabilise those with life-threatening injuries.
The same goes for when the injured person was the driver of the vehicle, as the RAF usually had to foot their bill.
He questioned why the private industry had to face the red tape of submitting a police accident report, witness reports and all other reports and documents before they were able to claim.
“We are not lawyers who need to submit these documents. We are medical service providers. Besides the fact that it is often difficult and time consuming to obtain these documents, Hleza said they also had to pay for some of it from their own pocket.
According to Hleza, they were even owed outstanding fees from before the RAF directive was issued this year. He said when they demanded these outstanding fees, the fund insisted on them complying with the directive, even though some of these claims were for services rendered before the directive was issued.
In an email to Letsoalo in August regarding the issue, Hleza said: “I’m sending you this email regarding private ambulance service grievances and most importantly, how road accident victims are suffering due to the changes in the new directive.”
Hleza said they were desperately waiting for answers from the fund.
“Private ambulance services no longer respond to accidents on time due to this issue ...
“Ordinary citizens are caught up in this battle that doesn’t involve them, yet they suffer because as organisations, we can’t sit down and resolve the issues,” he said.
Hleza referred to a recent incident where three metro officers died on the road as the private ambulance industry downed tools.
“We all know government ambulances take hours before they could attend to an emergency.”
Hleza said despite his appeal to the RAF, nothing had changed and the private industry, as well as the public, were still in the dark.
He said the cold facts were that private ambulances arrived on time at the scene of accidents and they serviced almost 95% of road accidents in the country.
According to him, it also benefited the RAF at the end of the day, as more harm to the patients was prevented, resulting in the fund having to pay less when a claim was instituted.
Asked for comment, RAF spokesperson William Maphutha said ambulances companies’ issues were receiving high level attention.
He said the RAF was in intensive talks with them. “It is also unfortunate that they want to apportion their challenges to the RAF; we are part of the stakeholders in the value business chain of ambulance services.
“Located at the tail end of all processes involved and therefore victims of road accidents should not suffer or left stranded. RAF is implementing processes to ensure efficient sustainable claims management processes and systems. Ambulances companies as part of our stakeholders are also being engaged, The RAD is open for engagement and will continue to do so across the board.”