Medical Insight Solutions
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.
From chronic disease lists to diagnostic conditions.
Knowledge of dispute resolution at funder level.
Ensure consistency between hospital tariffs, PMBs, and medical scheme reimbursement rules.
Where Patient Rights Meet Regulatory Reality –
We’ve helped:
PMB-compliant billing
PMB identification
PMB governance policies
Facing PMB challenges?PMBs Should Work For You, Not Against You
270+ conditions across chronic conditions, emergency and maternity care – we provide the full coded list.
Through:*
ICD-10 code alignment
Treatment pathway documentation
Scheme-specific rule citations
Yes – within 4 months of treatment date.
No ,unfortunately not