Day Clinics

Day clinics are healthcare facilities that provide surgical services and diagnostic procedures performed in an operating theatre on a same-day basis. They offer convenient alternatives to overnight hospital stays.

Some day clinics are attached to hospitals and others are independent and not part of any hospital. For instance, some Medicross Clinics have independent theatres. These facilities will only admit patients for the day. Specialists will also perform endoscopies in some casualties.

Benefits of utilising day clinics for patients:

Minimum disruption - procedure done on the same day, no overnight stay
Day clinics provide a less traumatic surgical environment compared to a hospital
The healthcare team that works with you does not change as there is only one shift, which makes it more personal experience
There is a reduced risk of hospital-acquired infections
Overall planning of procedures is more efficient compared to hospitals where emergencies will take priority. Day clinics plan admissions and procedures well in advance with fixed times and plan accordingly
Patients benefit from a quicker turnaround time and speedier recovery
Ease of admission and minimal forms to be completed
Lower costs for the same procedures
No co-payment for procedures such as endoscopies and cataract surgery (see below)

From which benefit does the Scheme pay for day clinic procedures?

Costs for procedures at day clinics will be paid by the Scheme (from the risk benefit), at the Scheme Reimbursement Rate, or at cost if PMB - not from your out-of-hospital benefits.

Avoid co-payments in hospitals and reduce costs for yourself and the Scheme

In the past, the Scheme experienced unnecessary high hospitalisation costs for procedures that could have been performed in a more cost-effective setting, for instance, a day clinic or doctor's rooms.

The Scheme, through Discovery Health, has negotiated competitive rates for day clinics and some other facilities for planned routine diagnostic gastroscopy, colonoscopy and other minor endoscopic procedures as well as for cataract surgeries.

To promote the use of these cost-effective alternatives, a co-payment was introduced, which will only be charged if members have one of these procedures done in a hospital instead of a day clinic.

For endoscopies (such as gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy) the co-payment is R3 615 if performed in hospital.
Emergency scopes, or scopes ordered if a patient has already been admitted for existing health concerns, will not be subject to a co-payment.
A co-payment of R1 130 is payable for cataract procedures performed in hospital, where these procedures can be done in a day clinic.

When obtaining your authorisation for these procedures, the Call Centre's authorisation team will advise if there are co-payments due and guide you on how to avoid them. The team will also be able to let you know which day clinics are available near you for the procedure you need to have done.

How do I find day clinics close to me?

For more information and a list of day clinics near you, please call us on 0860 222 633, or search for "Private Hospitals and Day clinics" in the Provider Search after logging in.

Please note the detail information that confirm it they are a Day Clinic and how they are covered. You can also search day clinics for endoscopies or day clinics for cataract surgery here. These lists will download automatically.

When you make the appointment, please confirm if the specialist that will be performing the procedure operates in a day clinic or from their rooms. Remember, a co-payment will apply if you are admitted to a hospital for a procedure that is not an emergency.

What happens in case of emergencies?

In the case of medical emergencies (as per the Medical Scheme's Act definition) please proceed to the closest facility - no co-payment will apply.

Day Clinics

From which benefit does the Scheme pay for day clinic procedures?

Avoid co-payments in hospitals and reduce costs for yourself and the Scheme

How do I find day clinics close to me?

What happens in case of emergencies?

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