BOOKLET COVER.pub - KwaZulu-Natal Department of Health

GJ CROOKES HOSPITAL
PATIENT ADMINISTRATION
SERVICES
OUR CLIENTS ARE OUR BUSINESS
ONLY THE BEST FOR YOU
Developed and compiled by Mrs. AE Wood and Patient Administration Staff.
Published: October 2002

GJ CROOKES HOSPITAL
ADMITTING DEPARTMENT
WHO WE ARE AND WHERE WE CAN BE FOUND: We are the Admitting
Department situated at the Bottom Section of the
Hospital near the Pharmacy Department.
OUR SERVICES AND BENEFITS
TO YOU:
1. Although we mainly provide services at a secondary level, we do provide some
services at a District Level for patients referred from surrounding clinics, for patient’s
generalist care and out patient care. We are open 24 hours a day.
2. We also have services rendered at out adult Primary Health Care Unit adjacent to
the Admitting Division (via Out Patient Division.)
3. The Health services in our country are changing and our services are in keeping with
Provincial and National Department of Health’s Policies.
DOCUMENTS YOU NEED TO BRING FOR YOUR FIRST VISIT:
1. Copy of your I.D Book.
2. Copy of your Pension card or book – whether private, civil or old age pension.
3. Copy of your latest Pay Slip (if married – copy of your spouses pay slip as well)
4. If unemployed, proof of unemployment, a U.I.F card, that is not older than 6 months –
plus supporting Affidavits stating that you are unemployed (if married, same for your
spouse)
5. If you are self-employed copies of your latest Tax Returns or VAT certificate for your
business or latest statement from your bookkeeper. If this is unavailable a Bank
Statement for the last 3 months would be required.
6. If you are on Medical Aid please supply your card.
FEES FOR OUR SERVICES
Fees are raised according to the fees laid down in the Government Gazette based on a number
of criteria such as your income and your medical aid. (See attached)
OUR SERVICE DELIVERY PRINCIPLES
We strive to provide our services in accordance with
1. Our Mission Statement
2. The Principles of Batho Pele (Umphakathi Phambili) namely “People First”
1

OUR MISSION STATEMENT
1. To provide High Quality Care according to the Health needs within our available
resources and current Provincial Policy.
2. Ensure dignity and rights of patients and staff.
3. Provide an exceptional work environment.
THE PRINCIPLES OF BATHO PELE (UMPHAKATHI PHAMBILI)
1. Consultation
2. Services Standards
3. Increasing Access to our services
4. Being Courteous and Helpful
5. Providing more and better Information
6. Increasing Openness and Transparency
7. Putting things right when they go wrong (Redress)
8. Giving Value for Money
9. Encouraging Innovation and Rewarding Excellence
10. Impact on Service
BASIC SERVICES OFFERED
1. Registering new patients after having been properly assessed by nursing staff for
Primary Health Care or Doctors visit.
2. Extracting of repeat cards for old repeat patients.
3. Collection of cash from paying patients, using proper delegations on free cases.
4. Provide certain Surgical Appliances and Certificates Of Fitness (COF), crutches,
walking sticks and rubbers.
5. Other appliances are paid for at Discharge Office and are obtained from Stores or
Wentworth Hospital.
6. We Admit and Discharge patients.
7. Safekeeping of Patients’ Private Property.
NB: Please tell us what you think of our services. We will use your input to improve on our
performance. You can write to us at:
THE HOSPITAL MANAGER
P/ B X5501
SCOTTBURGH
4180
OR phone us on Tel: (039) 9761300 on Extensions 2256/2295.
We, the Admitting staff hereby commit ourselves to meeting the standards reflected above.
2

SIKUNIKEZA INI
SINGOBANI THINA SI THOLAKALA KUPHI
Singumnyango omukela abantu sisendaweni ephansi eduze kwalapho kutholakala khona
imithi.
OKUTHO LAKALA KITHINA NOKUZUZAYO.
1. Nakuba sinikezela usizo lwethu ezingeni eliphansi, siya kezela ngosizo kulabo
abathunyelwa ama clinic esa khelene nawo ukuze banakelwe begciniwe noma
belashwa badedelwe.
2. Siphinde sisize futhi kumtholampilo oseduze nathi kuya ngalapho ku lashwa khona
(OPD). Usizo lweze mpilo luyashintsha ezweni lethu.
3. Usizo lwethu luncike emigomweni wesifunda nakuhulumeni omkhulu. Umnyango
uhlala uvuliwe (24 Hours)
OKUDINGEKA U KUPHATHE UMA U QALA
Ukuze u sebenzise kahle u sizo lwethu, sicela uphathe umazisi nencwadi esho u kuthi u hola
malini noma esho u kuthi awusebenzi noma imedical aid card kanye nemininingwane yakho.
IZIMALE EZE KHOKHWAYO
Uhlelo lokukhokha luhlelwe usomqulu kahulumeni ngezindlela eziningi njengokuthi uhola
malini kanye no medical aid.
IMIGOMO YOKUSEBENZA KWETHU
Sifuna uku sebenza ngohlelo olunemingomoethize:
1. Inqubo mgomo
2. Imigomo Yamphakathi Phambili
INQUBO MGOMO YETHU
1. Ukuthi sininikeze usizo lweze mpilo olu sezingeni oluphezulu okuncike kwesinako
kanye nomthetho omusha kahulumeni.
2. Ukuqikelela isithunzi namalungelo eziguli nabasebenzi.
3. Ukwakha ubudlelwanno obusezingeni eliphezulu loku sebenza.
1

IMIGOMO YA BANTU PHAMBILI (BATHO PELE)
1. Ukuxhumana nani
2. Izinga lokusebanza kwethu
3. ukwandisa ukuba sibambisane nani
4. Ukuzwela nokusiza
5. Ukunikezela ulwazi
6. Ukunyusela ukuveza zonke izinga obala
7. Ukubeka zonke izinto kahle uma konakele
8. Ukunikezela izinga eliphezulu
9. Ukwakhana nezinlomo
OKUJWAYLEKI LE ESISZA NGAKHO
1. Ukubhalisa bonke abaqaloyo emuva kokisa sebecutshunguliwe ngikazi odondene
nomtholampilo.
2. Ukukhipha amakhadi kulabo abaphindayo
3. Ukukhokhisa cabo abafanele ukukhokha nokuthi silingisele labo abangakhokhi
4. Sinikezela ngezinye zezi mpahla zabalimele noma abakhu bazekile, kany nezincwadi
zasem sebenzini
5. Ezinye zezimpahla zabakimele ziya khokhelwa kodwa zitholakale esitolonoma
Ewentworth
6. Siyalalisa noma sikhumle iziguli
NB: Sicela usazise ngoku cabangayo ngomntango wethu. Sizokusebenzisa konke ofisa
sikulungise ukunyusela izinga lethu.
Ungasibhalela noma u sushayele ucingo kulelikheli:
THE HOSPITAL MANAGER
P/Bag X5501
SCOTTBURGH
4180
UCINGO: (039) 9761300 Extension 2256/2295.
Thina basebenzi balomntango siyazinikela uku finyelela kulamazinga esiwa balile.
2

SERVICE ASSESSMENT FORM
ADMITTING DEPARTMENT
PLEASE TELL US WHAT YOU THINK
Pleasing our customers is the most important service we offer. You can help us maintain this
service by taking a minute to answer the questions below.
1. Was the Department clean? YES/NO
2. Did you receive excellent hospitality? YES/NO
3. Were you served speedily? YES/NO
4. How did/do staff welcome you in this
Department? EXCELLENT/MEDOCRE/
POOR
5. How effective is our service delivery? SLOW/MEDIUM/FAST
6. Do you know the people who are in charge
of the department in case you have a
problem? YES/NO
7. What is the estimated time that you feel you should wait to get your file on a busy
day? ___________________________
8. How would you like us to improve our Service Delivery?
_____________________________________________________________________
SUGGESTIONS:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
COMPLAINTS:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
QUESTIONS:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Please feel free to discuss anything about our services. Your views and
comments are highly valued.
Thank You.

IFOMU YOKUCWANINGS NGOKUSEBENZA
SIKHUNGO SOKUBHALISA
SITSHELE OKUCABANGAJO
Ukuthokozisa nina ikona okubalulekile kakhulu esi kwensayo/sodinga usizo lwenu ngoku
thatha umzuzu uphendule lemibuzo engezansi.
1. Uminyango ubuhlanzekile? YEBO/QHA
2. Uthole ukuphatheka okuhle? YEBO/QHA
3. Usheshiselwe? YEBO/QHA
4. Bakwemukela kanjanu abasebenzi balomnyango? KAHLE KAKHULU/KABI
5. Lushesha kangakanani usizo iwethu? KANCANE/
PHAKATHI NENDAWO/
LUYASHESHA KAKHULU
6. Uyabazi abantu abaphethe kulomnyango? YEBO/QHA
7. Isiphi isiglinganiso sesikhath ocabanga ukuthi
Kufanele usilinde uma kugcwele kakhulu? ________________________
8. Uthanda ukuba senzenjani ukunyusela izinga
Lokusebenza kwethu? ________________________________________________
SICELA NIGCWALISE KULOKHU
IMIBONO YENU:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
IZIKHALO YENU:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
IMIBUZO:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Sicela nikhululeke ukuxoxa nathi ngomsebenzi wethu. Imobono yenu
ingebalileke kakhulu.
Siyabonga

GJ CROOKES HOSPITAL
ADMITTING DEPARTMENT
ORGANOGRAM
HOSPITAL MANAGER
(Mrs. SP Nyawo)
(ACTING) ASSISTANT DIRECTOR : ADMIN.
(Mr. RP Appadu)
CHIEF ADMIN. CLERK : PATIENT ADMIN.
(Mrs. AE Wood)
ADMITTING SUPERVISOR
(Mr. BMC Mthethwa)
Mrs. CB Duma Mr. SR Dhaja Mr VA Khawula Miss. NG
Khuzwayo
(Admin. Clerk) (Admin. Clerk) (Snr. Admin. Clerk) (Snr. Admin.
Clerk)
Mrs DC Ntuli Mr ZP Nyawose Mr LF Sibisi Miss SV
Shangase
(Snr. Admin. (Snr. Admin. (Snr. Admin. Clerk) (Admin. Clerk)
Clerk)
Clerk)
VACANT VACANT
POST POST
MORTUARY
Mr. SA Nyawose
Auxilliary Serv.
Officer

GJ CROOKES RECEPTION DEPARTMENT
WHO: We are the Reception/Switchboard Department Staff members:
Mr. TR Cele Mrs. Rumba Gounder
Mr. Lucky Khomo Mrs. Prea Moonsamy
Mrs. HG Zama
Supervisor: Mr. Leslie Shibe
WHERE: We are situated in the top section of the hospital as you enter from
the parking lot area.
WHAT SEVICES DO WE PROVIDE?
PUBLIC: SWITCHBOARD – We answer all your calls and transfer you to the
department or ward at your request. We convey messages for some of the
patients. We attend to all your queries and help you as far as possible.
Time: We are a 24 hour service provider.
PRIVATE X-RAYS – We register all patients who are referred from Private
Doctors for X-rays.
STAFF: We answer your calls and make official outgoing calls. We make
announcements at your request once authority has been obtained. We attend to
all your queries and try to help you with as much information as far as
possible.
BIRTH REGISTRATION: We deal with the Registration of your baby’s birth with Home
Affairs on your behalf. Upon your six week visit to the Post Natal Clinic, you
may collect your baby’s Birth Certificate form the Sister.
MATERNITY CERTIFICATES - These are certificates for the confirmation of birth.
Time: 07H00 – 12:00
Day: Weekdays.
ANTE NATAL CLINIC – We provide patients with maternity files and blood tubes.
First Visits: Mondays and Fridays
Repeats: Tuesdays and Thursdays
Gynae: Wednesdays (by appointment only)
DENTAL CLINIC – We make files for first visit patients and the files are kept at the
Admitting Department.
Day: Thursdays
Time: 8:00 – 16:00
ADMISSIONS AND DISCHARGES – We admit and discharge female patients for wards
A, B and C (fees are to be paid on admission or before discharge.)

GJ CROOKES HOSPITAL
RECEPTION/SWITCHBOARD DEPARTMENT
SERVICE STANDARDS FOR OUR EXTERNAL CUSTOMERS
WHAT DOES THE RECEPTION/SWITCHBOARD AREA PROVIDE/DO?
We provide the following services:
Answering of the internal telephone calls and conveying messages.
Admission and discharges of female patients.
Issuing of Maternity certificates, Dental and X-ray files.
Collecting and receipting of monies for Oxygen Refills, Private X-rays,
Inpatients fees, MMF1/Insurance and Cremation forms and any type of
account payments.
Undertake classification and fee assessment of all in-patient and out-patients.
Assist the Home Affairs Department in the Completion of Birth Notification
forms of babies born at this institution.
Maintain the supply of BI1663 forms and issue same to wards.
STANDARDS FOR IMPLEMENTING
We strive to provide you with the best possible service and we commit ourselves to
answering your calls in under 5 (five) rings, to make your outgoing calls in under
5(five) minutes. We strive to obtain the best and the most important information
from you in order to complete your files and to convey messages correctly. We
will constantly update you on changes in fees to be paid.
CUSTOMER SATISFACTION
In order to continually provide you with the best service, the Department intends to:
Provide an information help line to enable you to give us your views
Consult you regularly on the services that we provide.

GJ CROOKES HOSPITAL
RECEPTION/SWITCHBOARD DEPARTMENT
INFORMATION REQUIRED
In order for us to complete your documents successfully, we will need the following
documents from you:
PATIENTS
STAFF
1. Copy of your I.D Book.
2. Copy of your Pension card or book – whether private, civil or old age
pension.
3. Copy of your latest Pay Slip (if married – copy of your spouses pay slip as
well).
4. If unemployed proof of Unemployment – a U.I.F card, that is not older than
6 months – plus supporting Affidavits stating that you are unemployed (if
married – same for your spouse).
5. If you are employed, your last salary advice and your spouses if married. If
you are self-employed, copies of your latest Tax Returns or VAT certificate
for your business or latest statements from your bookkeeper. If this is
unavailable, a Bank Statement for the last 3 months would be required.
6. If on medical aid please supply your card.
1. Copy of your I.D.
2. Persal Number.
3. If married spouse’s details and salary advice.
4. Complete the assessment form provided and return the documents to the
Revenue Department with a copy of your latest salary advice and your
copy of your I.D Book.
5. If on medical aid please supply your card.

GJ CROOKES HOSPITAL
RECEPTION QUESTIONNAIRE
Kindly complete this questionnaire and return it to the Reception Department or post it to:
THE HOSPITAL MANAGER
GJ Crookes Hospital
P/Bag x5501
SCOTTBURGH
4180
*
NAME: ________________________________________
TELEPHONE NUMBER: ( ) (H)
( ) (W)
________________________ (CELL)
POSTAL ADDRESS: ________________________
________________________
________________________
________________________
1. Were you pleasantly greeted when you were being attended to?
__________________________________________________________________________________
2. Were you satisfied with the services that you received?
__________________________________________________________________________________
3. Were you satisfied in the manner that you were attended to?
__________________________________________________________________________________
4. If you have ever phoned the hospital – was the telephone answered to your satisfaction, if not
please comment?
__________________________________________________________________________________
__________________________________________________________________________________
SUGGESTIONS
_____________________________________________________________________________________
_____________________________________________________________________________________
COMPLAINTS
_____________________________________________________________________________________
_____________________________________________________________________________________
REQUESTS
_____________________________________________________________________________________
_____________________________________________________________________________________
* Not compulsory – you may remain anonymous.
Your comments are nevertheless valued.

GJ CROOKES HOSPITAL
RECEPTION DEPARTMENT
ORGANOGRAM
HOSPITAL MANAGER
(Mrs. SP Nyawo)
(ACTING) ASSISTANT DIRECTOR : ADMIN.
(Mr. RP Appadu)
CHIEF ADMIN. CLERK : PATIENT ADMIN.
(Mrs. AE Wood)
RECEPTION SUPERVISOR
(Mr. Leslie Shibe)
Mr. TR Cele Mrs. Rumba
Gounder
Mr. Lucky Khomo
(Snr. Admin.
Clerk)
(Admin. Clerk) (Snr. Admin. Clerk)
Mrs. Prea
Moonsamy
Mrs. HG Zama
(Admin. Clerk) (Snr. Admin. Clerk)

WHO: STAFF MEMBERS
G J CROOKES HOSPITAL
REVENUE DEPARTMENT
Miss Elizabeth Book
Miss Thandi Cele
Mrs Abigail Chetty
Miss Geetha Maharaj
Supervisor: Mrs. Ansie Wood
WHERE: We are situated in the top section of the hospital, left
from Reception.
WHAT SERVICES DO WE PROVIDE ?
Completion of MVA / Insurance claim forms.
Follow up of unpaid accounts.
Setting up of accounts.
Receipting of payments – Cash and cheques.
Payment of Imprest money and Community Health
Workers’ salaries.

GJ CROOKES HOSPITAL
REVENUE DEPARTMENT
DOCUMENTATION REQUIRED
IN ORDER FOR US TO COMPLETE MOTOR VEHICLE ACCIDENT (MVA) AND
INSURANCE CLAIM FORMS, WE WILL NEED THE FOLLOWING DOCUMENTS:
MMF1 or Insurance claim form
Signed consent
Letter of request from attorney
A fee of R57.00 for completion of MVA/Insurance claim forms and copies of
Medical Records.
If forms are completed and copies of medical records are requested for
separately, a fee of R57.00 is required for each request.
IN ORDER FOR US TO SET UP YOUR ACCOUNT, WE REQUIRE THE
FOLLOWING:
1. YOUR CORRECT INCOME – In order to confirm this we need:
a) Bank Statement for the past 3 months
b) Salary Advices for both spouses.
c) Income Tax Certificate.
d) A completed assessment form available form our offices.
e) Pension card if Social Pensioner.
2. MEDICAL AID PATIENTS – to provide:
a) All documents stated in number 1 above
b) Valid Medical Aid card
3. STATUTORY PATIENTS – we require:
a) G111 form if patient is from Correctional Services.
b) SAP 70 form if patient is from the SAPS
The above documents must be correctly completed and stamped with
appropriate stamps from the departments responsible and signed by the
official from that specific department.
4. WCA ACCOUNTS – we require:
An employers report to be submitted on first consultation if an employee
was injured on duty. This document must be correctly completed with
the company’s registration number in the space provided and must be
signed by the employer. If the form is not supplied, the patient would be
required to pay the Hospital fees until such time as the report is supplied.

PERFORMANCE STANDARDS
REVENUE DEPARTMENT
TO ACHIEVE OUR TARGET OF R3.5 MILLION FOR
FEES COLLECTIONS AS A TEAM.
EACH MEMBER’S DUTIES COMPLIMENTS THE
OTHER’S, AIMING TO ACHIEVE OUR BIG GOAL.
TO TREAT ALL CLIENTS EQUALLY AND
RESPECTFULLY.
TO TREAT EACH OTHER WITH RECOGNITION AND
DIGNITY.

We are here to
assist you as soon
as the sun rises
REVENUE DEPARTMENT
GJ CROOKES HOSPITAL
Private Bag X5501
SCOTTBURGH
4180
Phone: (039) 9761300
Fax: (039) 9781295
ONLY THE BEST
FOR YOU.
GJ CROOKES HOSPITAL
REVENUE
DEPARTMENT

WHAT SERVICES DO WE
OFFER TO YOU?
• MOTOR VEHICLE ACCIDENT AND
INSURANCE CLAIMS
• WE SET UP YOUR ACCOUNTS
• FOLLOW UP OF UNPAID
ACCOUNTS
• RECEIPT PAYMENTS
• INJURY ON DUTY QUERIES
WHAT DO YOU NEED TO
ENSURE THE EFFICIENT
PROVISION OF THESE
SERVICES?
• MMF 1 Form
• R57,00
• Consent to release medical records
• Statement of accounts when paying
• Employers Report of Accident
• G111 or SAP 70 form
• I.D Book
Setting up of accounts
• We need your correct address, telephone
number and your medical aid
number, if you cannot produce
medical aid card you will be
requested to pay cash
• We need your I.D Book
IF I HAVE A QUERY WHAT
CAN I DO?
Telephonically
You can contact us telephonically on
(039) 9761300 07:30-16:00 on
Extension 2203,2207,2212 or the Head
of Department on ext 2216.
In person
or
You are most welcome to visit us in the
Revenue Department at
GJ Crookes Hospital.
Where about in the Hospital are we?
As you enter the Top Security Gate of
the hospital, turn left, walk straight towards
the Main Entrance, when you enter
you will see our Reception area.
Turn left as you enter and walk down
the passage, you should pass the Ante
Natal Clinic on your right hand side.

GJ CROOKES HOSPITAL
REVENUE DEPARTMENT
ORGANOGRAM
HOSPITAL MANAGER
(Mrs. SP Nyawo)
(ACTING) ASSISTANT DIRECTOR : ADMIN.
(Mr. RP Appadu)
CHIEF ADMIN. CLERK : PATIENT ADMIN.
(Mrs. AE Wood)
Miss Liz Book Mrs. Abigail Chetty Miss Geetha
Maharaj
Miss Thandi Cele
(Admin. Clerk) (Admin. Clerk) (Snr. Admin. Clerk) (Snr. Admin.
Clerk)