1 reviews | Active since Nov 2014
Mental Health PBM cover Errors..
Fwd: Prescribed Minimum Benefit funding for outpatient psychotherapy -MailRef#***#-5 August 2015<br> <br> Member number: ***<br> <br> Dear Mr Berowsky<br> <br> Your recent interaction with Discovery Health's Executive Office regarding your approved Prescribed Minimum Benefit cover for outpatient psychotherapy has reference.<br> <br> As a platform for this response, it is important to note that Discovery Health's basis for cover in terms of mental health is subject to the Prescribed Minimum Benefit as contemplated in the Discovery Health Medical Scheme Rules. Therefore, funding from Risk Benefits for any condition included in PMB Provision 902T is covered up to a maximum of either 21 days in-hospital treatment (including ECT) or 15 outpatient psychotherapy
Thank you for your comment.
Prescribed Minimum Benefit's (PMB) is a set of minimum benefits that, by law, must be provided to all medical scheme members. The cover it gives includes the diagnosis, treatment and cost of ongoing care for a list of conditions. Irrespective of one's personal plan-type, you are entitled to these benefits
I investigated your query and provided feedback telephonically on the way forward to appeal the funding decision. We understand that you may not be satisfied with the outcome of the query however it is in line with the Scheme rules.
Regards
Annelize
Thank you for your comment.
Prescribed Minimum Benefit's (PMB) is a set of minimum benefits that, by law, must be provided to all medical scheme members. The cover it gives includes the diagnosis, treatment and cost of ongoing care for a list of conditions. Irrespective of one's personal plan-type, you are entitled to these benefits
I investigated your query and provided feedback telephonically on the way forward to appeal the funding decision. We understand that you may not be satisfied with the outcome of the query however it is in line with the Scheme rules.
Regards
Annelize