Claims
How to make a claim
Check that your name and membership number are correct.
A claim is only valid for four months from the date of treatment. If you send it to us after four months, it will not be paid.
If you have paid your claim and wish to be refunded, check that your name and membership number are correct. You will also need to submit the proof of payment with the claim.
You and your dependants' identity numbers must be recorded with the Fund, in order to ensure that your claims are paid.
Claims may be submitted electronically by your doctors. You are responsible to check your statement to ensure that the claims have been submitted to us and paid.
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1
Check for the following information on your doctor's account/invoice.
REQUIRED INFORMATION helpThe Fund's registered name
The main member and the patient treated
The membership number
The doctor's practice number
ICD-10 codes
Signed proof of payment
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2
Sign and date the claim and sign the proof of payment.
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3
For Network Option:
Email
Scan or photograph each page, make sure that the quality is good.
Attach and email to us, email each page separately - no zip files or multiple attachments will be accepted.
Post
PO Box 2212
Bellville
7535ORFor Saver and Comprehensive Option:
Email
Scan or photograph each page, make sure that the quality is good.
Attach and email to us, email each page separately - no zip files or multiple attachments will be accepted.
Post
PO Box 15403
Vlaeberg
8018 -
4
Upon processing claims, a claims statement will be generated and sent via email or post. The claims will be reimbursed in two-week cycles.
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Claims are reimbursed into your bank account upon claims processing.