medical schemes Archives

2 Mar , 2017

Managing cash flow in a hostile administrative environment

cash flow, Medical Aid Funds, medical schemes Best Practice

There can be no doubt that the administration of the claims of one ambulance private ambulance service by a competing private ambulance is potentially anti-competitive. However, in the absence of intervention by auth...

29 Dec , 2016

Negotiating a sustainable tariff for your ambulance service

Monika Vermeulen

Medical Aid Funds, medical schemes, sustainable tariff Best Practice, Medical Aids

It needs to be emphasised private ambulance service owners or managers remain responsible for the final negotiation and acceptance of tariffs for the coming year. While many medical aid scheme representatives may rel...

5 Sep , 2016

Designated Service Provider Networks for EMS

Monika Vermeulen

Council for Medical Schemes, Medical Aid Funds, medical schemes Medical Aids

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 by th...

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...