GEMS only pays for claims if services are from a health professional with a PCNS number
The Practice Code Numbering System (PCNS) is a list of unique practice billing codes for providers of healthcare services in South Africa. The practice number, allocated to all registered healthcare providers, is a legal requirement for the process of reimbursement of a claim to either a medical scheme member or service provider. The Medical Schemes Act 131 of 1998 states that a medical scheme may only reimburse a member or a provider of relevant healthcare services for services rendered against a valid practice number. GEMS may therefore only pay for claims if services are from a professional with a PCNS number.
