3365512
Descrição
Mapa Mental por Tshegofatso Tlhong, atualizado more than 1 year ago
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Criado por Tshegofatso Tlhong
quase 9 anos atrás
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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
- route PMB claims where there is no hospital authorisation?
- 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
- Claims
- How would the benefit accumulation be calculated?
- Dual Accumualtion?
- Dual Accumualtion?
- How will we manage the subilmits?
- Our concern is that claims have never been able to pay through the sublimit
- Our concern is that claims have never been able to pay through the sublimit
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