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How to Making a claim with Thebemed

Name of the Organization : Thebemed
Type of Facility : How to Making a claim with Thebemed
Head Office : Johannesburg
Website : https://www.thebemed.co.za/

How to Making a claim with Thebemed

Making a claim is simple with Thebemed :
** We understand that medical care can be expensive and stressful.
** That is why we make our claims procedure as easy as possible.

Related : How to claim LA Health Medical Scheme : www.southafricain.com/4678.html

Who can claim?
** The member or the healthcare service provider (for example, a doctor, pharmacy or hospital) can make a claim.

How is the claim processed?

** The Claims Department receives the claim and assesses it according to the Scheme Rules.
** If the Scheme Rules allow, the claim will then be paid.
** Sometimes additional information is required from you or your healthcare service provider when assessing claims.
** If this information is not available, some claims may not be paid in part or in full.

When are claims paid?
** We make weekly claims payments.

What information must be on your claims?

** Your member number;
** The Scheme name;
** Your benefit option

** Your surname and initials;
** The patient’s name and beneficiary code as it appears on your member card;
** The name and valid practice number of the service provider;
** The date of service;

** The nature and cost of treatment;
** The pre-authorisation number, if applicable;
** The tariff code;
** The relevant ICD-10 and relevant diagnosis code;

** Your signature to confirm that the account is valid; and
** If you paid for the service, attach proof of payment and highlight it clearly. Proof of payment can be either a receipt from
** the healthcare service provider, an electronic fund transfer (EFT) slip or a bank deposit slip.

Submit your claims correctly :
By post to :
P O Box 4709,
Johannesburg, 2000
** You may give your claims to a Thebemed Agent on site

Note :
** If you are entitled to make a claim through any of our schemes, simply get in touch with one of our advisers.
** We will ensure that your claim is processed as quickly as possible.
** Call us on 0861 THEBEMED/0861 84 32 36 and we will advise you of the correct procedure for submitting a claim and getting paid.

** Should you have any complaints or queries about your claim, after it has been sent through to the scheme and you have received feedback, then please escalate your claim to complaints AT tybhealth.co.za

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