Medical Insight Solutions

– Bridging Clinical Need with PMB

PMB Governance

PMB's Made Simple

In South Africa’s PMB are legislated , we help:
✔ Members secure rightful reimbursements
✔ Medical schemes implement compliant PMB frameworks

Our dual expertise in PMB governance and clinical pathways maximize your PMB benefit.

Why Choose Our

PMB Service?

Where Patient Rights Meet Regulatory Reality –

Empowering
Healthcare Through Smart Consulting SolutionS

We’ve helped:

  •  PMB-compliant billing

  • PMB identification 

  • PMB governance policies

Our PMB Action Framework

Facing PMB challenges?

PMBs Should Work For You, Not Against You

Help Centre.

Got questions?

What conditions automatically qualify for PMBs?

270+ conditions across chronic conditions, emergency and maternity care – we provide the full coded list.

How do we prove PMB eligibility?

Through:*

  • ICD-10 code alignment

  • Treatment pathway documentation

  • Scheme-specific rule citations

Can you help with historic PMB claims?

Yes – within 4 months of treatment date.

Do you assist with CMS complaints?

No ,unfortunately not 

Still Have Questions?

Get in touch with us.