Pinnacle Medical Consulting (PMC) is a South African based organisation that has been formed to bridge the gap between medical aid members, healthcare providers and medical aid schemes, by assisting members of medical aids with all things pertaining to medical aid queries, i.e. claims resolutions on behalf of members and Healthcare service providers, obtaining pre-authorisations, tax / medical aid certificates and providing informed clinical advice on the different medical aid options and benefits – with a special focus on member's healthcare needs and affordability Detailed Services are:• Obtain pre-authorisation from Medical Aid schemes on behalf of our clients.• Engage Medical Aid schemes and Healthcare Providers on both a clinical and benefit perspective to resolve any unpaid medical aid claims.• Make continuous and systematic follow ups on all medical aid claims to ensure that claims are paid timeously and correctly.• Assist on registering our Clients on Prescribed Minimum Benefits (PMB's) and Chronic Disease List (CDL's) with their Medical Aid Schemes in order to enjoy the full scale of benefits.• Negotiate discounted rates with Healthcare Providers according to the National Regulatory Price List (NRPL) guidelines in cases where the medical costs exceed our client's benefit.• Apply for ex-gratia from Medical Aid schemes on behalf of our clients in cases where benefits have been depleted• Provide informed medical aid advice pertaining to different medical aid options and benefits – with special focus on our Client's healthcare needs and financial position.• Requests Medical / Tax certificates on behalf of our clients at the beginning of every Tax year for timeous submission to the South African Revenue Services (SARS).• Report unresolved medical aid queries and claims that we feel Medical Aid schemes have handled unscrupulously to the Council for Medical Schemes or The Ombudsman depending on the nature of the complaint.