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3365512
Internal PMB Worskhop
Description
Internal PMB Worskhop
No tags specified
pmb
discussion
seeking clarity
Mind Map by
Tshegofatso Tlhong
, updated more than 1 year ago
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Created by
Tshegofatso Tlhong
about 9 years ago
12
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Resource summary
Internal PMB Worskhop
Funding Of PMB's?
Claims
route PMB claims where there is no hospital authorisation?
Decline any claim related to treatment that falls outside PMB level of care
Route a declined auth where a claim is PMB
Where there are no DSP's across the country will we fund at cost?
Automated or PMB Application?
Definate PMB only?
OH Auths =PMB ICD Code, Procedure and Within the date range
How would the benefit accumulation be calculated?
Dual Accumualtion?
How will we manage the subilmits?
Our concern is that claims have never been able to pay through the sublimit
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