Submit a claim within 4 months following service date
You need to send us your claim by the last day of the 4th month following the month in which you received the service. If we receive the claim after this date, you will need to pay any outstanding amounts to the provider.
Check that we have your correct banking details
Claims refunds are only paid into a South African bank account by electronic funds transfer (EFT). Please call us on 0860 102 493 if you need to update your banking details.
Check your account and receipt
Make sure that your membership number is clearly shown on both the account and the receipt. Please ensure that the account shows the following:
- Your name and initials
- Your membership number
- The treatment date
- The name of the patient as shown on your membership card
- The amount charged
- The tariff
- The ICD-10 code
Please check that prescriptions for medicine show all your details and that the correct amount for medicine dispensed is shown on the claim. If the pharmacy omits any of these details, we will not be able to process your claim.
Email the account to us at firstname.lastname@example.org.
Login or call us on 0860 102 493 to follow-up on whether the account has been paid.