Terms and Conditions for Admission:

Kiaat Private Hospital

TERMS AND CONDITIONS FOR ADMISSION

KIAAT PRIVATE HOSPITAL (PTY) LTD

The patient is admitted to the Kiaat Private Hospital (Pty) Ltd (“Hospital”) on the Terms and Conditions as set out below. Any reference to Hospital shall, where the context allows, include a reference to Kiaat Private Hospital (Pty) Ltd, its subsidiaries and associated companies.

GUARANTEE OF PAYMENT

Any person who signs this admission form as the patient, or on behalf of the patient or as guardian or as guarantor of the patient (“signatory”), whether on admission, during the patient’s hospital stay or on the patient’s discharge from the Hospital:

  1. Agrees thereby to be jointly (where applicable) and severally liable for payment of the Hospital account in respect of the services rendered to the patient including the pharmacy account notwithstanding any claim arising from a medical scheme third party funder or insurance cover. Any Signatory shall remain bound notwithstanding that the patient has not signed this admission form.
  2. Is expected to have acquainted him/her/themselves with all the terms and tariffs applicable upon admission to the Hospital and, specifically, to have noted that:
    • The daily tariff is in respect of accommodation (including ward stay, meals and general nursing care);
    • The full Hospital account (which may include, but is not limited to, accommodation, theatre time, gasses, equipment, pharmacy stock, and miscellaneous items such as telephone use, etc.) in respect of the patient’s stay at the Hospital, the services rendered and medication and/or other goods dispensed from the pharmacy is payable in full upon rendering thereof or on discharge;
    • Doctors, Anaesthetists, Specialists and any other Private Healthcare Professional’s fees are not included in the Hospital account and will be billed separately;
    • A copy of the terms and tariffs applicable to private patients are available at the Hospital’s reception; AND
    • The terms and tariffs for patients covered by medical schemes or third-party funders vary, and the hospital accepts no responsibility for shortfalls, co-payments, or exclusions. Please communicate directly with the patient’s medical scheme/third party funder for the applicable tariffs prior to admission.
  3. Warrants hereby that (if applicable):
    • The patient is a legitimate member of the medical scheme/third party funder mentioned in this admission form, and his/her membership is valid as at the date of signature of this admission form; OR
    • The Signatory is a legitimate member of the medical scheme/third party funder mentioned in this admission form, his/her membership is valid as at the date of signature of this admission form, and the patient is a legitimate dependent in terms of such membership.
    • In the event that such membership is invalid, suspended, or rejected, the Signatory shall remain jointly and severally liable for all hospital charges incurred.
    • The Signatory further undertakes to notify the Hospital immediately of any changes in the patient’s or Signatory’s medical scheme or third-party funder membership, benefits, or coverage status during the course of admission. Failure to provide such notification shall not relieve the Signatory of liability for any hospital charges incurred.
  4. There are sufficient medical scheme/third party funder benefits available for the patient to cover the patient’s admission and treatment, and acknowledges liability for any shortfalls, co-payments, or exclusions; AND
  5. That he/she warrants that they have full contractual capacity, that their estate has not been provisionally or finally sequestrated, and that they are not subject to any administration or debt review order. They acknowledge that this declaration is a material inducement for the Hospital to provide non-emergency services on credit.
  6. Authorises the Hospital to:
    • Disclose to the medical scheme/third party funder the nature of the patient’s illness and/or any operations or procedures performed on the patient, including the relevant diagnosis and procedure codes (i.e. CPT/ICD/SADA codes) for purposes of processing an account; AND
    • Present for payment to the medical scheme/third party funder any account owed to the Hospital in respect of the patient, on behalf of the patient and/or Signatory (“Debtor”). Notwithstanding the aforesaid, it is specifically agreed that it remains the Debtor’s duty to ensure that all accounts are received by the medical scheme/third party funder timeously. The Hospital shall incur no liability in instances where accounts are not submitted to the medical scheme/third party funder timeously.
  7. Undertakes in the event of an account being unsettled for any reason:
    • To pay interest calculated at the rate of 2% per month on any amounts due after 30 days of the patient’s discharge; AND
    • Where the account is referred to attorneys for collection to be jointly and severally liable for the payment of all costs on an attorney and own client scale, all collection commission and all tracing costs. All outstanding amounts will be recovered in the following order: attorney’s fees, collection commission, tracing fees, interest and lastly capital.
    • The Hospital reserves the right to require a deposit or suspend non-emergency services if accounts remain unpaid.
  8. Chooses domicilium citandi et executandi (the physical address where legal notices may be sent) at the address provided in this admission form.

CONSENT TO COMMUNICATION AND INFORMATION PROCESSING (POPIA)

  1. I hereby consent to the Hospital processing my personal information (and special personal information, where applicable) in accordance with the Protection of Personal Information Act, 2013 (POPIA). This processing is limited to the purposes of providing medical treatment, hospital administration, and billing.
  2. I understand that the hospital may contact me via SMS, email, or secure electronic links.
  3. I understand that I may withdraw this consent at any time.

DFS.PA.018