What is a Designated Service Provider (DSP)?

By using proven and affordable interventions in accordance with Medical Scheme rules, a Medical Scheme may appoint a Designated Service Provider (DSP) or Provider Group, to provide members with the diagnosis, treatment and supply of medication of Prescribed Minimum Benefit (PMB) conditions. In this case, the member of the Medical Scheme may only use the Service Provider as designated by the Medical Scheme and all costs within the Medical Scheme rules will be paid in full by the Medical Scheme to the DSP.

Where a member decides to use the services of a provider that is not a DSP, a co-payment or levy may be imposed on the member by the Medical Scheme, except if the service was involuntarily obtained, i.e. in respect of an emergency condition. A medical condition that is of a sudden and unexpected onset and that requires immediate medical or surgical treatment is considered an emergency condition. Failure to provide this treatment would result in impairment of bodily functions, serious dysfunction of bodily organ or part, of would place the person’s life in serious jeopardy.