Docline manages the utilisation of Prescribed
Minimum Benefits for medical schemes while applying governing scheme
rules as well as overarching legislation. In addition protocols,
formularies etc. may be applied.
The prescribed minimum benefits are a set of medical
diagnoses and chronic diseases that a scheme must cover according
to the medical schemes act.
Docline manages these benefits on behalf of the
scheme by means of:
- Negotiating preferred provider agreements
- Applying scheme rules and benefits with regard to these benefits
- Constructing PMB formularies
- Monitoring and managing hospital benefits
- Reporting on the above
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