Medical Schemes often do not pay everything they should for Medical Emergencies and other Prescribed Minimum Benefit (PMB) treatments. 

Medical Emergencies must be paid for in FULL by the Medical Scheme, even if the medical service provider is NOT a Designated Service Provider (DSP) including related services such as pathology and radiology.

Under specific conditions non-Emergency PMBs are payable in FULL.

Claims Hound can help.

• Claims Hound engages with the Medical Scheme on behalf of your patient to get the treatment classified as a Medical Emergency and accordingly paid in full as a PMB.
• No need for you to get directly involved in the dispute with the Medical Scheme.
• Once the Medical Scheme/Insurer agrees to increase the benefits you and the member are informed of the extent of the increase.
• The Medical Scheme is requested to make payment directly to you and not the member.
• Simply refer the patient to Claims Hound.