Focus on cardiac dysrhythmia

What is Cardiac Dysrhythmia?

Cardiac Dysrhythmia, commonly referred to as an arrhythmia, is characterized by an irregular or abnormal heartbeat. This condition arises when the electrical impulses responsible for regulating the heartbeat malfunction, resulting in the heart beating either too quickly, too slowly, or in an irregular pattern. Individuals experiencing heart arrhythmias may describe sensations such as fluttering or racing in their chest. While many arrhythmias are benign and pose little to no risk, some can lead to significant complications, including potentially life-threatening symptoms that require immediate medical attention.

The signs and symptoms of cardiac dysrhythmia

• A fluttering sensation in the chest can be disconcerting and may indicate an underlying issue with heart rhythm.
• A racing heartbeat, known medically as tachycardia, can occur unexpectedly and may be accompanied by other symptoms.
• A slow heartbeat, referred to as bradycardia, can also manifest, leading to feelings of fatigue or weakness.
• Chest pain may arise, which should always be taken seriously as it could signal a more severe heart condition.
• Shortness of breath is another common symptom, often experienced during physical activity or even at rest.
• Light-headedness or dizziness can occur, potentially leading to fainting or near-fainting episodes.
• Excessive sweating may accompany these symptoms, indicating the body’s response to stress or an underlying cardiac issue.
• Fainting (syncope) or near-fainting episodes can be alarming and often necessitate immediate medical evaluation.

Possible causes of cardiac dysrhythmia

Various factors can contribute to the development of an arrhythmia, including:

• Current heart attacks can disrupt the heart's electrical system, leading to dysrhythmias.
• High blood pressure can strain the heart and alter its rhythm over time.
• Blocked arteries in the heart can impede blood flow, triggering irregular heartbeats.
• An overactive thyroid gland, known as hyperthyroidism, can accelerate the heart rate and cause arrhythmias.
• Conversely, an underactive thyroid (hypothyroidism) can also influence heart rhythm.
• Smoking is a significant risk factor that can damage the heart and blood vessels, increasing the likelihood of arrhythmias.
• Drug abuse, particularly stimulants, can lead to serious heart rhythm disturbances.
• Stress, both chronic and acute, can impact the heart's electrical system, resulting in dysrhythmias.
• Diabetes can contribute to cardiovascular complications, including arrhythmias.

How to register on the chronic programme

Upon receiving a diagnosis of Addison’s disease, it is important to take the necessary steps to register for the Chronic Medicine Management Programme. You should request your physician to reach out to our Chronic Medicine Department at 0860 11 78 59 for assistance with the registration process. Our chronic medicine consultant will collaborate with your healthcare provider to establish an appropriate treatment plan. Following the submission of necessary diagnostic criteria and blood test results, your treatment will be assessed and approved. We will inform you whether your treatment is included within the Momentum Medical Scheme formulary or if a co-payment will be required. After receiving authorization, you can present your prescription to your designated service provider to obtain your medication, and the claim can subsequently be submitted. A designated service provider (DSP) is a healthcare professional, such as a doctor, pharmacist, or hospital, that the medical scheme prefers for the diagnosis, treatment, or care of conditions classified under Prescribed Minimum Benefits. Should you opt to use a non-designated service provider, additional co-payments may apply. It is important to note that authorization typically expires after 12 months. If there are no changes in your medication regimen, your doctor or pharmacist can contact us at 0860 11 78 59 to renew the authorization. This same procedure applies if there are any modifications or additions to your treatment plan.

For further information about your chronic benefits and where to access chronic medication and treatment, please click here.

Hospitalisation

In the event that you require hospitalization due to complications from cardiac failure, you can easily initiate the pre-authorization process by logging into the Momentum App. Alternatively, you may reach out to us through the web chat feature available on momentummedicalscheme.co.za, send us an email at [e-mail], message us via WhatsApp, or call us directly at 0860 11 78 59. Once your request is received, we will assign a case manager to monitor your hospital stay and ensure you receive the necessary support.

Treatment plan

Once you are successfully registered in the programme, you will gain access to a comprehensive treatment plan. This plan may encompass coverage for essential tests, medical consultations, and other benefits deemed medically necessary by your healthcare provider. Our clinical team will review these components to ensure they are appropriate for your specific health needs.

Compliance

It is crucial for your health and well-being to adhere to the following compliance measures:

• Ensure that you obtain your chronic medication on a monthly basis without fail.
• Take your medication precisely as prescribed by your doctor, paying close attention to the dosage and quantity.
• Do not miss any doses, as this can have serious repercussions on your health and may hinder the effectiveness of your treatment.

Please ensure your claims have the appropriate ICD-10 code

For all claims submitted, it is vital that they include the correct ICD-10 codes (diagnostic codes). This is essential for accurately identifying the claim and facilitating payment from the Chronic Benefit.

We may pay claims from your Day-to-day Benefits if:

• The claims are submitted without the necessary ICD-10 codes.
• You have exceeded the allowed frequency for consultations or tests.
• The treatment provided is not considered clinically appropriate.

Contact us

If you have any questions or require assistance, you can reach us through the web chat feature on momentummedicalscheme.co.za, send an email to [e-mail], message us on WhatsApp, or call us at 0860 11 78 59.

Glossary of terms

Designated service providers are healthcare professionals and facilities that Momentum Medical Scheme collaborates with to provide diagnosis and treatment for its members' Prescribed Minimum Benefits. This network may include associated general practitioners (GPs), specialists, and state facilities, depending on the specific circumstances.

A formulary is a comprehensive list of medications that are covered under your specific medical plan, from which your doctor can prescribe the most suitable medication for your chronic condition.

ICD-10 refers to the International Classification of Diseases, 10th Revision, which is the standardized system of diagnosis codes.

Prescribed Minimum Benefits represent a set of essential healthcare services that all medical schemes in South Africa are mandated to cover under the Medical Schemes Act 131 of 1998 and its accompanying regulations. To qualify for these benefits, the following criteria must be met:

• Your medical condition must be recognized as qualifying for coverage and included in the defined list of Prescribed Minimum Benefit conditions.
• The treatment required must align with the services outlined in the defined benefits.
• You must utilize the Scheme’s Designated Service Providers. For more information, please refer to the definition of Designated Service Providers mentioned earlier.

If you choose to use non-designated service providers voluntarily, the Scheme will reimburse benefits up to the Momentum Medical Scheme Rate, and relevant co-payments will apply. However, if non-designated service providers are utilized in cases of emergency medical conditions, this is considered involuntary, and co-payments will be waived.