Prescribed Minimum Benefits
Identifying valid PMB conditions on diagnosis information alone is not always appropriate, therefore there is an application/authorisation process that is required (PMB Application form). This can either be done before a single event or recurring events (like chronic medication) or after an event such as an emergency. There is also an appeals process for members to query the funding of PMB claims. The appeals committee reviews the case and will contact the member with feedback. Information on PMB's is also available on the Council for Medical Schemes' website. Should you require information on the location of the nearest DSP, please contact the PROVIDENCE clinical risk management team on (041) 395 4481 or the customer care team on (041) 395 4474.