Benefit Overview
A clear view of relevant medical scheme benefits, coverage structures and key information for the practice.
Practice & Specialist Benefit Information Books
The Practice & Specialist Benefit Information Books provide detailed medical scheme benefit information for practices and specialist teams, structured for quick and easy lookups.
How the range is structured
Clear structure for easier access.
Services, Procedures and Benefits
Practical detail covering services, procedures, scheme reimbursement benefits and treatment settings.
Medical Scheme Benefit Funding and Authorisation Rules
Information about medical scheme benefit funding, limits, exclusions and authorisation rules that affect access to care.
Specialist areas
Information for specialist areas.
Dental & Maxillofacial Benefit Information Book
Eye Care & Ophthalmology Benefit Information Book
GP & Specialist Benefit Information Book
Orthopaedic Benefit Information Book
Mental Health Benefit Information Book
Women’s Health Benefit Information Book
Oncology Benefit Information Book
Radiology & Diagnostic Imaging Benefit Information Book
Pulmonology & Respiratory Benefit Information Book
Renal & Nephrology Benefit Information Book
Urology Benefit Information Book
Cardiology Benefit Information Book
Pathology & Laboratory Benefit Information Book
What these books cover
- In-hospital and out-of-hospital benefits
- Services and procedures
- Treatment settings
- Medical scheme benefit funding
- Scheme reimbursement benefits
- Limits and exclusions
- Authorisation rules
- PMB rules
- DSP conditions
- Extended treatment information
- Changes and midyear changes
Who it is for
Designed for general practices, specialist practices, allied healthcare providers, medical administrators, and healthcare professionals who need medical scheme benefit information to support patient care and practice management.
Simple, flexible access
Each book is an annual Excel reference edition, structured for practical access and updated to reflect the latest medical scheme information, including relevant midyear changes.
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