– 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?
PMB Knowledge
From chronic disease lists to diagnostic conditions.
Dispute Resolution
Knowledge of dispute resolution at funder level.
Cross-Platform Alignment
Ensure consistency between hospital tariffs, PMBs, and medical scheme reimbursement rules.
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
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