Focus on cardiac dysrhythmia

 

Below is information about cardiac dysrhythmia 

Cardiac dysrhythmia, also known as heart rhythm problems, arises when the electrical impulses responsible for regulating your heartbeat fail to function properly. This malfunction can lead to a variety of heart rates: your heart may beat too quickly, too slowly, or in an irregular pattern. Individuals experiencing heart arrhythmias might notice sensations such as a fluttering or racing heart, which can sometimes be benign. However, it is important to recognize that certain types of heart arrhythmias can lead to significant symptoms that may be bothersome or even pose serious health risks.

The signs and symptoms associated with cardiac dysrhythmia can vary widely and may include:

• A fluttering sensation in the chest, which can often be alarming to those experiencing it.
• A racing heartbeat, known medically as tachycardia, where the heart beats faster than normal.
• A slow heartbeat, referred to as bradycardia, where the heart beats slower than the standard rate.
• Chest pain, which can range from mild discomfort to severe pain, and may indicate more serious issues.
• Shortness of breath, which can occur during rest or physical activity, signaling that the heart is struggling to pump effectively.
• Light-headedness or dizziness, which may lead to fainting or near-fainting episodes (syncope).
• Excessive sweating, often occurring without exertion, which can be a sign of stress on the heart.

There are numerous potential causes of cardiac dysrhythmia, and understanding these can help in managing the condition. Some of the common causes include:

• A current heart attack, which can disrupt the normal electrical pathways of the heart.
• High blood pressure, which places additional strain on the heart and can lead to arrhythmias.
• Blocked arteries in the heart, reducing blood flow and potentially causing irregular heartbeats.
• An overactive thyroid gland (hyperthyroidism), which can increase heart rate and lead to arrhythmias.
• An underactive thyroid (hypothyroidism), which can also affect heart rhythm.
• Smoking, which harms cardiovascular health and can trigger arrhythmias.
• Drug abuse, particularly stimulants, which can significantly alter heart rate and rhythm.
• Stress, which can lead to physiological changes that affect heart function.
• Diabetes, which can damage blood vessels and nerves that control the heart.

If you have been diagnosed with cardiac dysrhythmia, it is crucial to take the next steps in managing your condition. You should ask your doctor to reach out to our Chronic Medicine Department at 0860 11 78 59 to register you in the Chronic Medicine Management Programme. This program is designed to provide comprehensive support and management for individuals with chronic conditions. A consultant from the chronic medicine team will work closely with your physician to develop an appropriate treatment plan tailored to your needs.

Once the necessary diagnostic criteria have been satisfied and relevant blood tests have been submitted, your treatment will be reviewed and approved. You will be informed whether your prescribed treatment is covered under the Momentum Medical Scheme formulary or if a co-payment will be required. After receiving authorization, you can take your prescription to your designated service provider (DSP) to obtain your medication, and the claim can then be submitted for processing. A designated service provider is a healthcare professional or facility that is preferred by the medical scheme for managing specific conditions. Should you choose to seek treatment from a non-designated provider, you may incur additional co-payments.

It is important to note that the authorization for treatment typically expires after 12 months. If your medication regimen remains unchanged, either your doctor or pharmacist can contact us at 0860 11 78 59 to renew the authorization. The same procedure applies if there are any modifications or additions needed for your treatment plan.

In the event that hospitalization is necessary due to complications from cardiac dysrhythmia, you can easily initiate the pre-authorization process. You may log in to the Momentum App, utilize the web chat feature on momentummedicalscheme.co.za, email us at [e-mail], send a WhatsApp message, or call us directly at 0860 11 78 59. A dedicated case manager will be assigned to oversee your hospital stay and ensure that all necessary arrangements are made.

Once you are enrolled in the Chronic Medicine Management Programme, you will gain access to a comprehensive treatment plan. This plan may encompass coverage for essential tests, consultations with doctors, and other medically necessary benefits as determined by your healthcare provider. Our clinical team will review these benefits to ensure they are appropriate for your condition.

Compliance with your treatment plan is vital for your health. You are expected to:

• Obtain your chronic medication on a monthly basis to maintain consistent treatment.
• Adhere strictly to the prescribed dosage and quantity as directed by your doctor.
• Ensure that you do not miss any doses; this is critical not only for adherence but also for your overall health and well-being.

It is essential that all claims submitted include the correct ICD-10 codes (diagnostic codes) to ensure accurate processing and payment from the Chronic Benefit. Claims that do not include these codes may be paid from your Day-to-Day Benefit instead. This could occur in situations where:

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

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

Glossary of terms

Designated service providers: The Momentum Medical Scheme collaborates with a network of designated service providers, including associated general practitioners and specialists, as well as state facilities, to ensure our members receive the necessary diagnoses and treatments for Prescribed Minimum Benefits.

A formulary is a specific list of medications that are covered under your chosen option, from which your doctor can prescribe appropriate medications for your chronic condition.

ICD-10 refers to the international classification of diseases diagnosis codes.

Prescribed Minimum Benefits represent a defined list of benefits that all medical schemes in South Africa are required to cover, as stipulated by the Medical Schemes Act 131 of 1998 and its regulations. To access these benefits, the following criteria must be met:

• Your medical condition must qualify for coverage and be included in the list of Prescribed Minimum Benefit conditions.
• The required treatment must align with the treatments specified in the defined benefits.
• You must utilize the Scheme’s Designated Service Providers. For more information regarding Designated Service Providers, refer to the definition provided earlier.

If you voluntarily opt to use non-designated service providers, the Scheme will reimburse benefits up to the Momentum Medical Scheme Rate, and relevant co-payments will apply. In cases of emergency medical conditions, using non-designated service providers is considered involuntary, and co-payments will be waived. If your medical condition and treatment do not meet the criteria for accessing these benefits, reimbursement will be based on the benefits available under your selected option.