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POLMED Member Queries Process

Name of the Organization : POLMED
Type of Facility : Member Queries Process
Head Office : Arcadia

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Website : https://www.polmed.co.za/members/my-medical-scheme/query-process/

POLMED Member Queries Process

** If you have a query and would like to speak to a POLMED Client Service Call Centre agent you can contact POLMED via telephone on 0860 765 633.

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Related : POLMED Claims Submission Process : www.southafricain.com/2539.html

** Alternatively send your query/application via fax to 0860 104 114 or send an email to polmed AT medscheme.co.za

Note :
** The Administrator has five (5) working days to respond to and resolve your initial enquiry.
** Always obtain a reference number and name of the agent.
** It is extremely important that you follow the correct process in order for us to assist you.

Member Queries (Initial Query) :
Admin/Managed Care (Clinical)/General Queries :
** These are queries you raise with the Administrator when you initially experience a problem with or require information with regard to any medical scheme-related matter.
** A reference number will automatically be supplied to you when you submit your query via email.

** Remember to also obtain a reference number and the name of the agent when you report any matter to POLMED’S Client Service Call Centre.
** Submit your query to polmed AT medscheme.co.za

Provide the following information for the Administrator to investigate your query :
** Membership number
** Patient name and surname
** Dependent code (i.e. 01 – refer to the back of your membership card)

** Date of service
** Name of the provider
** Practice number of the provider
** Details of enquiry that may further assist POLMED to investigate the matter
** Supporting documents i.e. invoice / statement / medicine – or medical procedure declined

Member Queries Escalated

** These are queries that serve as a follow up to your first query after you have not received satisfactory feedback/service.
** The query received at POLMED will be investigated and feedback will be provided to the member within a minimum of five (5) working days.

** The number of days depends on the complexity of the enquiry i.e. more information required from the member/provider to resolve the query.
** Send an email to polmedhouse AT medscheme.co.za

Provide the following details for POLMED to investigate your query :
** Membership number
** Patient name and surname
** Dependent code (i.e. 01 – refer to the back of your membership card)
** Reference number obtained from the Administrator (you should have requested this when the initial query was raised)
** Date of initial enquiry
** Details of the enquiry that may further assist POLMED to investigate the matter

Additional Polmed Contact Details

** Chronic Medicine Management registration: polmedcmm AT medscheme.co.za
** Ambulatory Prescribed Minimum Benefit (APMB) registration: polmedapmb AT medscheme.co.za
** Hospital pre-authorisation: polmedauths AT medscheme.co.za
** POLMED Chat (via mobile device): Download the free POLMED Chat app on your device
** POLMED Chat (via POLMED website): Log in to the member zone and click on the POLMED Chat widget/icon

Client Service Call Centre And Regional Offices : Operating Hours
** The POLMED Client Service Call Centre and Regional Offices operate Mondays to Fridays from 7:30 to 17:00 (excluding public holidays).
** Please click here to view the address details of the various Regional Offices.

Compliments :
** If you want to submit a compliment about a positive experience that you had with the Scheme, send an email to polmed AT medscheme.co.za and include the details of your experience and the name of the agent who assisted you.

Online/Social Media Comments And Queries :
** The POPI Act prohibits the Scheme from disclosing any member’s personal information to third parties without a member’s consent.
** It is for this reason that POLMED cannot communicate with you via any social media platform such as Facebook, Twitter and Instagram or any other social medium.

** POLMED further has an agreement with the Administrator whereby we monitor their level of service offered to members.
** If the formal processes are not followed, it is impossible to monitor or measure these service levels.

Some Important Information From Comments

Comments:
1. I am writing this message very disappointed by Polmed service regarding the benefits that are forever not paid in time for consultations and hospitalization short falls. I am constantly phoned by different doctors personal assistance regarding their money which Polmed didn’t pay. Please assist me.

2. I have been trying to request hospital authorization for two weeks without any success, very disappointed in Polmed response. It was never like this before.

3. I called in twice this morning requesting for authorisation approval because the doctor did not receive it and he needed it asap. I left my email address but still waiting. Each time, I called they told me its approved and the authorisation was sent but, its difficult for them to resent the approval to me. Please I need assistance as soon as possible because the doctor is waiting.

Information:
Most of the commenters commented that, they are facing the problem while trying to request hospital authorization

13 Comments
Add a Comment
  1. Anonymous

    I want to change my email address. Makumbila nico i will comment after reply.

  2. Disappointed Member

    Don’t know if this will do any good. service polmed members are receiving of late is pathetic. cannot get through on the phone line. keep getting “the number you have dailed does not exist”

    phoned medscheme to connect to polmed only to be told they cannot see to my query as I am not the main member and need authorisation from my husband to make any queries.

    then passed the number of medscheme to my husband. he also had to phone medscheme to get to polmed.
    our problem is thag chronic meds go from out of hospital benefit…and it depletes it quite quick every year. was told that we need to submit our scripts to polmed to authorize chronic meds and wait for approval before going to the pharmacy….which i find pathetic. but anyways…at the pharmacy i was told that the doctor should apply for chronic meds….pharmacy lost my script…so i need to go back to the doctor but nowadays doctors charge for a reprint of a script.

    also…polmed was supposed to pay out a refund last week…took them a month to finalize the claim…now 6weeks after the actual claim was submitted I am still waiting on the refund.

  3. Kim mthembu

    Hi I’m writing this message very disappointed by polmed service regarding the benefits that are forever not paid in time for consultations and hospitalization short falls. I’m costastly phoned by different doctors personall assistance regarding their money which polmed didn’t pay. Pls assist me.

  4. Thabile Moloi

    I have paid the doctor the consultation fee, can I get the correct email address for the claim, to claim back the money from the medical aid.

  5. charmaine nzo

    Hi. I called in twice this morning requesting for authorisation approval because the doctor did not receive it and he needed it asap, I left my email address but still waiting. each time I called they told me its approved and the authorisation was sent but, its difficult for them to resent the approval to me. please I need assistance as soon as possible because the doctor is waiting.

  6. Ezekiel matsebedi

    Iam a polmed member I have registered my new born baby by of mosibudi matsebedi polmed number 640052XXXXX I just want to find out whether does she appear on the system because she has been admitted at hospital

  7. mapitsi meso

    I was admitted at zamokuhle lenmed hospital on 2021 .12.08 and out on the 17 December 2021. lancet do some blood tests as directed by my physician. polmed dint pay all the bloodtests. iam on Marine option.when I call polmed they said they paid all money. when I go to lancet they still outstanding amount on my account. Dissatisfied patients

  8. Claire

    Hi
    What is the e-mail address for authorizations for Polmed?

  9. Gavin Gillham

    I have been trying to request hospital authorization for two weeks without any success, very disappointed in Polmed response. It was never like this before.

  10. Mrs Mapaseka Tladi

    membership no:64004961710,polmed refused to reinstate membership

  11. Warrant officer Phineas mmanare malebane

    Kindly reinstate medical aid as I was medically boarded last month. membership no 6400528XXXX idno
    68042457XXXXX

  12. Chris nzimande

    Hi IM An exmember of the Saps my polmed no is2700093547_8 my ID no 68010653XXXXX my membership was suspended please reinstate on a lower plan.I was medically bosses following an injury on duty IM on chronic medication.

    p

  13. Lindokuhle Nhlabathi

    I have requested a membership card several times & there is no response. I only receive emails but no card.

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