Discovery ProPBM for pharmacies
Discovery Health's own pharmacy claim and benefit management system
Discovery ProPBM, our pharmacy claim management system was established to offer the medical schemes we administer a comprehensive range of managed care services. In keeping with this strategy, we have our own price file, which is key to the accurate functioning and benefits of using Discovery ProPBM.
Who to contact
Real-time medicine claim and price queries | Discovery ProPBM call centre | 0860 776 726 | ProPBM_QUERIES@discovery.co.za |
Chronic medicine authorisation / confirming benefits | Chronic Illness Benefit Division | 0860 400 600 | Chronicqueries@discovery.co.za |
Remittance advices and payment | HealthPartners call centre | 0860 445 566 | Healthpartnerinfo@discovery.co.za |
Updating supplier price files/product information, out of stock notifications | Price and Product File | 0860 776 726 | Price_and_Product_File@discovery.co.za |
Health Technology Assessment (HTA) process, Approved product lists, Approval for Digital technologies & new equipment, annual price adjustments |
Surgical Drug Risk | ISEM@discovery.co.za | |
Formulary considerations (only SAHPRA registered schedule 3-6 products) | Drug Risk | drm_team@discovery.co.za | |
New technology review | Center of Clinical Excellence | cpuwatchlist@discovery.co.za | |
NAPPI code registration and review process | NAPPI Code Registration and Review Process Guide | ||
Registering your pharmacy at Discovery Health | HealthPartners call centre | 0860 44 55 66 | Provider_administration@discovery.co.za |
Register your pharmacy to receive payment from Discovery Health
We settle claims promptly and with the highest possible level of accuracy. To ensure we pay your claims for dispensing medicine to members of the schemes we administer, we need you to register with us. This also ensures we can communicate updates with you and give you information that is relevant to your practice.
Please use this coversheet to guide you through the practice registration process. It simplifies the process with check lists, it provides links to the forms and agreements, it clearly spells out your requirements, and it makes sure we receive all the information we need to successfully complete your registration in the shortest of time.
Please complete the coversheet and send it to us along with:
- BHF client information sheet
- Certified copy (with date not older than three months) of the South African ID document or passport document of the practitioner/owner
- Most recent SAPC registration certificate of the pharmacy
- Certified copy of the authorized signatories' ID document, passport or valid driver's license
- VAT registration document (if applicable).
- Completed Healthcare professional banking details for the payment of claims form
- Completed Healthcare professional practice management and web access details form.
- Completed Healthcare practice registration form.
Note: if we do not have your banking details, we will pay the claims your practice submits to our members.
You can email or fax the registration details to us
As soon as you have filled in these forms, you can fax all the information to us at 011 539 2784 or email it to Provider_administration@discovery.co.za
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You can download the following pharmacy documents:
- Discovery Health Standard Network and DSP Agreement
- Discovery Health pharmacy network guide
- Chronic Illness Benefit application form
- Chronic Illness Benefit medicine list (formulary)
- KeyCare acute medicine list (formulary)
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You can download the following pharmacy clinic documents:
- Pharmacy clinic tariffs 2024
- Diabetes Clinic Network agreement
- Diabetes Educator Network handbook
- Diabetes foot screening form
- Diabetes educator activity record
- Diabetes educator mentorship form
- Diabetes pathology laboratory referral form
- Diabetes Practice registration form
- PCDT Network agreement
- PCDT Handbook
- PCDT Practice registration form
- KeyCare Primary Care Clinic Handbook
- KeyCare Primary Care Clinic pathology referral form