Submit a Claim

Submitted by mindq on Tue, 09/17/2019 - 14:25

Learn on How to Claim

First Name

Last Name

Date on which service was rendered

Email Address

Contact Number details of service provider and patient

Practice location of the professional rendering the service

Number of the professional rendering the service

Code number of Items/ recognised tariffs

Copies of original documents should be certified by the supplier of the service e.g. prescriptions

One file only.
20 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Referrals

Yes

Copy of referral letter

The referral letter and presciption have a three month validity period.

One file only.
20 MB limit.
Allowed types: jpg, pdf.

Membership Number

Attach Signed Invoices

Make sure that the invoice is signed by yourselves. Also ....

One file only.
20 MB limit.
Allowed types: jpg, pdf.

Attach Receipts/Proofs of PaymenT

One file only.
20 MB limit.
Allowed types: jpg, pdf.

Name of benefit option

Contributions Calculator for Individuals

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Contributions Calculator for Individuals

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