1) Acceptance, Scope and South African Regulatory Context
By accessing or using MedCascade you agree to these Terms. MedCascade operates in South Africa and supports healthcare billing-assist workflows subject to South African law, including the Protection of Personal Information Act 4 of 2013 (POPIA) and the regulatory framework of the Council for Medical Schemes (CMS). If you do not accept these Terms, do not use the Service.
2) What MedCascade Is (and Is Not)
- Billing-assist only: MedCascade helps you prepare clinically aligned coding, motivations and documentation. We do not submit claims to medical schemes and arenot a medical scheme or administrator.
- No guarantee of payment: Recommendations are guidance only and do not guarantee scheme benefit entitlement, PMB recognition, authorisation or reimbursement.
- Clinical and financial responsibility remains with the healthcare provider and/or practice. Always verify coding, PMB status and tariff applicability with your professional judgement and the patient’s scheme rules.
3) CMS and Tariff Notes (RPL/NHRPL)
- RPL and NHRPL historically refer to the same SAMA/MDCM procedure coding set. Schemes may apply their own tariffs, rules and benefit restrictions; outcomes vary per scheme and option.
- PMB: Diagnosis and Treatment Pairs (DTPs) and PMB rules are scheme-administered. Provider coding must be clinically justified. PMB entitlement is determined by the scheme in line with the regulations and applicable clinical protocols.
- “Tariffs” functionality is a coming soon feature and may list scheme tariff references where available; such references are indicative only and not a quotation or guarantee.
4) Your Responsibilities
- Provide accurate, lawful data and maintain all necessary patient consents/authorisations. You warrant that you have a lawful basis under POPIA to disclose special (health) information to us for processing.
- Review, validate and, where necessary, amend all recommendations before use. You are responsible for final coding, claims and communications to schemes.
- Comply with professional, HPCSA, CMS and scheme requirements applicable to your practice.
5) Acceptable Use
- No unlawful, defamatory, discriminatory or misleading submissions.
- No uploading of personal information without a lawful basis (consent, contract or other POPIA ground).
- No reverse engineering, interference, scraping, or circumvention of security or rate limits.
- No use to build competing datasets/models from our outputs without our written consent.
6) Data Protection and Roles
For patient and practice data you upload, your organisation is the POPIA “responsible party”. MedCascade acts as an “operator” processing such information under your instructions. For our own account, security, billing and communications data, MedCascade is a responsible party. OurPrivacy Policy forms part of these Terms.
- Security safeguards, operator agreements with sub-processors and cross-border transfer controls are maintained as described in our Privacy Policy.
- You must implement appropriate access controls and obtain/record consents and authorisations where required.
7) Subscription, Credits and Fees
The Service may be billed on a credit-based or subscription basis. Fees are payable in advance and are non-refundable, save where required by law. We may suspend access for non-payment. Usage beyond plan limits may incur charges.
8) Disclaimers
- Clinical and coding disclaimer: Content may contain errors or be incomplete. It is intended for use by qualified professionals and must be independently reviewed.
- No warranties: The Service is provided “as is” and “as available” without warranties of any kind.
- Third-party content: Scheme rules, tariffs and clinical protocols may change without notice.
9) Limitation of Liability
To the maximum extent permitted by law, MedCascade is not liable for indirect or consequential loss, loss of profits or business interruption. Our aggregate liability for all claims in any 12-month period is limited to the fees you paid for the Service in that period.
10) Indemnity
You indemnify MedCascade against claims, penalties or losses arising from your unlawful processing of personal information, breach of these Terms, or misuse of the Service, including claims by patients, schemes or regulators.
11) Suspension and Termination
We may suspend or terminate access for breach, security risk, non-payment or legal requirements. You may terminate on notice; we will follow the data return/deletion process described in the Privacy Policy and our Data Processing Addendum (if in place).
12) Governing Law and Disputes
These Terms are governed by the laws of the Republic of South Africa. Disputes relating to medical scheme benefits (including PMB) must be pursued through the scheme’s processes and, where applicable, the CMS. Disputes with MedCascade will be resolved in South African courts of competent jurisdiction.
13) Changes to the Service or Terms
We may update the Service and these Terms from time to time. Material changes will be communicated via the platform or email. Continued use constitutes acceptance of the updated Terms.