Prescribed Minimum Benefits

 
 
 
 
 
 
 
 

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