Council for Medical Schemes Archives

5 Sep , 2016

Designated Service Provider Networks for EMS

According to the Medical Schemes Act, 1998, Regulations, Chapter 3: Contributions and Benefits, 7: Definitions, a Designated Service Provider is defined as: “…a health care provider or group of providers selected...

24 May , 2016

Prescribed Minimum Benefits: What you need to know

Monika Vermeulen

Council for Medical Schemes, medical schemes, PBM, Prescribed Minimum Benefits Best Practice, Medical Aids

The Prescribed Minimum Benefits (PMB) are a list of 270 medical conditions that medical schemes are always liable to provide cover for, in order to ensure that scheme members are guaranteed a minimum level of cover – re...

26 Feb , 2016

Lodging a complaint with the Council for Medical Schemes (CMS)

Monika Vermeulen

CMS, complaint, Council for Medical Schemes Best Practice

Did you know that if a medical aid fund, or an administrator acting on behalf of a medical aid fund with regards to the administration and payment of ambulance claims, has not paid your claim promptly and in full, that...