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The Council for Medical Schemes provides a downloadable Excel file containing the final version of the ICD-10 five-character coding standard for Prescribed Minimum Benefits (PMBs), as defined in 2005. This file is intended for use by medical schemes, healthcare providers, auditors, and brokers to ensure consistent application of PMB codes.
The Council for Medical Schemes provides a downloadable reference document that outlines the ICD-10 coding standards used by medical schemes in South Africa. This document is intended to guide accurate classification of medical diagnoses for claims processing and reporting.
This is a dataset containing aggregated compliance information from medical schemes in South Africa for the first quarter of 2010, based on ICD-10 diagnostic coding standards. It includes statistical summaries used for monitoring and regulatory oversight.
This is a publicly accessible legal case file from the Council for Medical Schemes. It contains information related to a dispute between an individual (Dr AR M) and Discovery Health Medical Scheme. The file can be downloaded and viewed by anyone interested in the case details.
The Council for Medical Schemes provides a downloadable erratum document that corrects errors in the South Africa ICD-10 Coding Standards Version 4. This document is available for use by healthcare providers, coders, auditors, and other stakeholders involved in medical scheme compliance.
The Council for Medical Schemes provides access to the addendum to the UPFS minor theatre procedures. This document outlines updated or supplementary guidelines related to minor theatre procurement processes for regulated entities such as medical schemes, auditors, brokers, and brokerages.
The Council for Medical Schemes provides a downloadable discussion document that outlines communication guidelines for medical schemes. This document is intended to guide medical schemes in their communication practices with members, stakeholders, and regulators.
The public can access the full text of the High Court judgment delivered on 27 November 2013, which concerns a legal dispute between the Council for Medical Schemes and Hosmed Medical Scheme. The document is available for download and preview online.
The Council for Medical Schemes provides access to the Explanatory Memorandum on Model Rules for medical schemes. This document explains the framework and guidelines that medical schemes must follow. It is available for download at any time.
The South African ICD-10 Coding Standards, Version 4 provides a comprehensive framework for the classification of diseases and health conditions used by medical schemes and healthcare providers across South Africa. It ensures consistency in reporting and claims processing.
The Council for Medical Schemes provides public access to a High Court judgement concerning Hosmed Medical Scheme. This document is available for download and review by anyone interested in medical scheme regulation and legal proceedings.
A document available for download from the Council for Medical Schemes website, detailing information related to a legal or regulatory matter involving two medical schemes. It is accessible to the public and can be used for reference by stakeholders such as medical scheme members, brokers, auditors, and regulated entities.
