Author: Cristina Van Der Merwe

There is so much new information and processes you will be confronted with when you open your own practice, and a million different things to keep in mind, that you could ask yourself: “If I studied psychology to help/ assist/ interact with humans… why am I spending so much time on paperwork, computer programs and all these codes?” The ICD-10 is just one of the codes you will have to be familiar with.

What is ICD-10 and why do I need to use it?

ICD-10 stands for the International Classification of Diseases and health-related problems (10th revision). It is produced by the World Health Organisation (WHO), and since January 1, 2005, all healthcare practitioners in South Africa are required, by law, to use this system. The coding is applicable to both the private and public sector.

Where do I get more information on it?

A CD containing the ICD-10 codes is available to all BHF (Board of Health Funders) members or can be ordered from them at clientservices@bhfglobal.com. The list on the CD is updated bi-annually on the 1st July to include the WHO updates. There are organizations that provide training on the use of ICD-10 codes, which can be obtained from the BHF.

But why do we have to use them?

The benefits to the health care industry are numerous, but the most pertinent include:

• Profiling of disease, which could improved research and treatment plans.
• It allows for regional and international comparisons of the frequency and occurrence of disease
• It is important for the development and implementation of disease management programs and risk management.
• It allows for appropriate management of medical services and benefits
• Generation of faster payment of claims by the medical aids

How are the codes structured?

The 1st character is a letter and is associated with a specific chapter. A chapter indicates a group of related conditions. This is followed by a numeral. The code can be 3, 4 or 5 characters in length, but codes with 5 characters are not often used in a psychology practice. The more characters in the code, the more specific it is e.g.

F30 Condition (Manic episode)
F30.2 More specific (Mania with psychotic symptoms)

Remember: the code has to be to the highest level of specificity.

Which chapters should I be interested in?

The chapters often used by psychology professionals depend on the area of expertise and is usually covered by:

F00-F99 Mental and Behaviour Disorders
G00-G99 Diseases of the Nervous system
R00-R99 Symptoms and signs involving cognition, perception, emotional state and behaviour
Z00-Z99 Factors influencing Health Status and contact with Health Services

Can you be more specific?

The following are some examples of codes used in different psychology practices.

F34.1 Dysthymia
F41.2 Mixed anxiety and depressive disorder
Z63.5 Disruption of family by separating and divorce

Terminology you need to be familiar with:

NOS Not otherwise specified – this implies certain information is not qualified and usually ends with a 9
NEC Not elsewhere classified – this alerts the coder to find a more specific code if available.
Principle diagnosis: This refers to the reason for the encounter with the service provider and may differ from the initial or working diagnosis.
Secondary diagnosis: This refers to additional conditions which affects the patient care or coexist with the main condition.
Co morbidity: This is a pre-existing condition which may or may not require more resource usage e.g. a disease that accompanies the main diagnosis which also requires treatment.

Who has access to these codes and what about confidentiality?

Although the medical schemes state that ICD-10 codes will be handled in the same manner as all personal details and clinical information contained on medical accounts, the patient has to be informed and sign a consent form indicating whether the practitioner is allowed to include/ not include the ICD-10 code on the account. If the patient requests not to display the code, the following codes should be used:

U98.0 Client refuse
U98.1 Service provider refuse

Alternatively the client can pay the service provider, knowing he/she will not be ale to claim this from the Medical scheme.

We can all learn from each other, so please share your experiences, thoughts and additional useful information with us and fellow professionals. Please comment below, or send me an email at: christina@jvrafrica.co.za

Author: Anna-Rosa le Roux

As psychologists in consulting, whether you are positioned internal to a company, running your own practice or working as associates within a consulting company, we are all ‘burdened’ with the creative or laborious task to market and secure our services through proposals.

The engagement meeting as first step in proposal writing

The proposal is a formal vehicle for conversation with the client. In the proposal we differentiate ourselves from our competitors and establish our unique value proposition. We specify what we offer (solution) at what price, to address the client’s very specific needs. In the proposal we need to communicate and demonstrate that we are confident and capable to deliver the services that we say we do, thus an important document positioning ourselves and setting the client at ease.

The Process

The first step in writing proposals is to listen very carefully to the client explaining their need and then to pose critical questions to firstly aid understanding, but also to guide the client towards further insight and clarification. I think back to Edgar Schein who said that every interaction with the client needs to be one where the client experiences value and gets something more than the previous engagement. The consulting process therefore already starts at the proposal writing stage and specifically at the engagement meeting.

Some initial considerations and questions

In this section I highlight some themes that might be helpful to consider if you are privileged to meet with the client before writing the proposal. I also include some real life commentary from seasoned consultants when I interviewed them on this topic:

• Understanding expectations – This concept refers to the clarification of exactly what the expectations are, as well as the likely process to be followed.
  

  “ … it is an understanding of what the client wants, it is an understanding of where the client comes from, it is understanding of his own needs as he expresses them – and what we are going to do to ensure that we deliver against expectations, and educating the client in terms of our methodology.”

• Agree on high level outputs – This concept refers to the agreement of high-level deliverables pertaining to the project.
  

  “ … what is the end product going to look like”

• Budgeting and resourcing – This concept refers to the importance of sufficient funding and resources to be available to carry out the intervention successfully.
  

  “Most of the time the interventions fail, not because they are not good, but because you under-cost them”

• Client maturity – This concept refers mainly to the ability of the client to understand and embrace the solution at a holistic, integrated, strategic level.
  

  “That is why you would judge a client and then define their solution just based on what they can handle”.

• Stakeholder readiness – This concept refers to the ability of the client to embrace change and must be taken into account prior to commencing the project.
  

  “ … the people that are mature and ready for it, will work with you, and go through the process as and when required. The people that are not ready will put up a lot of resistance, because they do not see the need for the change”.

• Leadership supports the proposal/ change – In any initiative it is important that the different levels of leadership in the organisation understand, buy in and visibly support the change initiatives.
  

  “ … either they (the leadership of the organisation) are not there, or do not take on the role successfully. They need to visibly show their support through communication to the various stakeholders”.

At the initial engagement meeting we thus aim to understand the client’s needs, the process to be followed, and the outputs that they require. Consideration also needs to be given to organisational enablers such as level of support, stakeholder readiness, budgeting and client maturity.

Feel free to comment below or send me an email at: anna-rosa@jvrafrica.co.za

Author: Andrea Swanepoel (Psychometric Advisor)

JvR would like to assist our clients and further improve our client service, by demystifying some of our company processes. This article-, and others in future, will highlight the “how to” of ordering, scoring, researching, reporting, training and more. In this article we will highlight some important points to remember when ordering printed test material.

Ethical, Professional and Legal Considerations

All of us at JvR subscribe to the ethical and best practice professional standards of national and international psychological associations such as the Health Professions Council of South Africa (HPCSA), the American Psychological Association (APA) or the British Psychological Society (BPS) and others.

In South Africa, psychological tests are only available to appropriately qualified professionals registered with the HPCSA. We therefore routinely ask for your HPCSA registration number on all orders received.

JvR offers internationally accredited trainings on some of our assessments. The purpose of such training is, amongst others, to ensure that the use of the assessment is on par with international best practice. It also provides an opportunity for adding you to a list of internationally accredited clients. When test material of these assessments, are ordered, we also verify your accreditation status before processing the order.

Many of the psychological tests, distributed by JvR, can however be ordered without having to undergo further training. We do however still need to know your current registration as Psychologist or Psychometrist with the HPCSA, when your order is placed.

The ordering process works like this:

Whilst wondering which assessment(s) would best fit your specific need and context, you are very welcome to visit us at the office for a cup of coffee where we can provide you with all the information you need. If you prefer to browse, at your own leisure, through all the choices we can offer you, please visit our electronic catalogue site at www.jvrcatalogue.com.

Of course you are also very welcome to phone or e-mail us for any information you may require. We will also gladly send you a quote for the assessments you require. Our quotes are valid for 15 days.

Once you have decided on the assessment or combination of assessments that you need, we will ask you to complete an Order Form and, if you are a new client, a Data Form. You can request these forms directly from us in the Psychometric Advisory Department via phone (Johannesburg:+27 11 781 3705 or Cape Town:+27 21 913 0541) , or by e-mailing us at info@jvrafrica.co.za.

You can visit our offices where you submit your Order Form and, depending on stock, can wait for us to process your order. Your completed Order Form and Data Form can also be sent to us via email or by using the following fax numbers: Johannesburg: +27 11 781 3703 or Cape Town: +27 21 913 0542. Please remember to be very specific as to the assessment material required and do not forget to sign your order form! We will process your order within the next 24 hours depending on the availability of stock.

Please take note that should you be registered with the HPCSA in supervised practice, the Supervising Psychologist will also have to sign your Order Form.

Stock of test material

It is important to note that we do not always carry stock of all the tests displayed in our catalogue. Should you order test material that we do not have in stock we will notify you that your request has been placed on, what we call “back order”. This implies that the test material has to be imported or printed and it may take up to three weeks for delivery. In very rare circumstances an international distributor may also have run out of stock or may even have decided to discontinue a test. Should this happen we will let you know and also do our best to seek alternative solutions for you. It is however, always best to place your order as early as possible allowing us time to possibly import or print the test material you require. It may be useful for you to keep in mind that our orders to most international distributors are placed in the middle of the month (the 15th) and at the end of a month (the 30th). It might save you time to submit your order to us before these dates.

Processing of an order

We capture all the information from the Data Form onto our client database. The information in this database is confidential. Based on a new entry into our database, and with some verification, your account with us will be opened.
In South Africa, this account number is in your personal name as the HPCSA registered Psychologist or Psychometrist. In future, this account number should be used as reference whenever you are making any payment to JvR.
Your Order Form will be processed within 24 hours. Factors that may affect the speed of processing include the availability of stock as well as the accuracy of the information on the order form. Should there be a problem with the order we will phone you to provide feedback or ask for clarity.

Delivery or Collection Methods

You are very welcome to visit our offices for a cup of coffee and to personally fetch your package of test material.
Should you ask us to send your test material via secure postage or courier, the costs will be added to your invoice. You are welcome to verify these costs before we send you the material.

Please be aware that courier costs are influenced by your choice of over- night- or on the same day delivery.
We can only ensure same-day delivery if we receive your order form before 10am on the day of delivery. Overnight delivery requires that the order form reach our offices before 3pm.

The cost of such a courier service is also dependent on the size and weight of each parcel. When utilizing the courier service it is important to provide us with a physical address where the parcel needs to be delivered. In some instances, such as after hour’s deliveries, a secondary address is also required. Please ensure that a contact person is available when the delivery is made.
It is very important to note that the courier service only delivers to rural areas once a week and not daily!

Speed post, as secure form of postage can also be considered. Speed post usually takes up to three days for delivery to a Post Office near to you. We will provide you with a tracking number for your parcel to enable you to follow up should the parcel not arrive in the allocated time.

Although we do our utmost best to ensure that your parcel reaches you in good condition and as soon as possible, it is not possible to accept responsibility for the internal processes of the courier service or the Post Office.

International orders will only to be sent by reputable courier services as JvR cannot be held responsible for damage or loss of such material. Pre-payment of such an order will be required.

Payment can be made in several ways:

We prefer payments to be made electronically (EFT) but will also accept bank deposits, cash or credit card payments.
For us to allocate your payment correctly it is absolutely essential that you add your unique account number to your EFT payment or your bank deposit. Make it a habit to fax or e-mail us your proof of payment as this ensures that you will not receive further invoices for money that has already been paid.

Our existing clients have 30 days, from the date of invoicing, to settle their account. Our policy is to block accounts that are overdue and to charge interest on late payments. We also require all purchases of R1000.00 and less to pay for the material before it is released. Unverified or new clients have to provide proof of payment before the test material is made available to them.

In Summary:

We value our business relationship and will do our best to make your experience of our service positive. We appreciate all feedback which can help us to enhance our offering even more. Please send such feedback directly to jopie@jvrafrica.co.za.

In next month’s article we will describe how electronic test material is purchased, accessed and scored.
If you have any queries relating to this article, or our ordering processes, please leave a comment or email either fatima@jvrafrica.co.za or myself at andrea@jvrafrica.co.za

For many psychologists, starting a Private Practice is a daunting and lonely place to be. Don’t despair, support networks abound, all you have to do is tap into them. Here is a 4 point plan to get you started:

1. Affiliate
   Apart from your HPCSA registration you need to affiliate yourself with a professional Psychology body in South Africa (e.g., PsySSA, SIOPSA etc). You may even want to join international bodies (e.g., the American Psychological Association (APA) or Centre for Creative Leadership (CCL) etc). There are many to choose from, and your areas of interest will dictate which will be the most beneficial to you.
2. Read applicable practise documents
   Documents like the National Health Reference Price List (NHRPL) will guide you when setting your pricing structure for the year. Click here to check it out.

   A very useful document is the report produced by Health Management and Networking Services (HealthMan) appointed by PsySSA to conduct practice cost surveys that will determine appropriate benchmark tariffs for recommended inclusion in the Reference Price List 2010. This report can be found here.

   It has a wealth of useful information, and will, for example, remind you about hidden costs that you need to account for, to ensure a viable and sustainable business. For example, rent and utilities, bad debts, finance and insurance, practise management and administration.
   Another important reference is the ICD-10 codes which you need to include on your invoices if your clients want to claim from their medical aids. You can find an online directory of the codes here.

3. Join a CPD Group
   There are many opportunities to earn your 30 CPD points each year. It may be through courses run by various institutions, universities, companies ( JvR CPD Programmes) or by joining a reading group. No reading groups in your area? Then take the initiative and set one up! It is a great way to meet colleagues in your area and develop a robust referral network. Speak to Robert Mondi at the HPCSA to find out how to register a group for CPD points.
4. Find a Mentor
   I know it is said that one learns from your mistakes, but why make mistakes if you can avoid them! Seek out an experienced practitioner whom you respect and who is willing to supervise or mentor you. Be willing to pay for their time, but try to negotiate a slightly reduced rate that will suit your budget.

Whether you are new to the field of psychology or have years of experience, we can all learn from each other. If you have additional comments or experiences you would like to share, please post and we will incorporate it into the document.

The January edition of our newsletter will contain some usefull articles around starting up your own practice and the basics of working in our industry. If there is something that’s always been bothering you, or something you just can’t seem to figure out, post about it! You might find something in this month’s newsletter – so if you are not on our mailing list, just enter your name and email in the top right hand corner of this website. If it’s not for you, you can always unsubscribe