Bankmed Medical Scheme Submit a Claim

Organisation : Bankmed Medical Scheme
Facility Name : Submit a Claim
Applicable For : Southafrican Citizen
Website : https://www.bankmed.co.za/portal/individual/submit-a-claim

Bankmed Submit a Claim

Healthcare Professionals, hospitals and pharmacies in our networks usually send us your claims directly. If you use a network provider, you do not have to send us a claim. You only need to submit a claim if you have paid the Healthcare Professional and you need to claim the money back from us.

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Introduction

** You must submit your claim within four months from the date of service. After this, the claim expires, and you will not be reimbursed.
** Make sure your membership number and the Healthcare Professional’s details, including their practice number, are clear on the claim.

** Submit a detailed claim and not just a receipt. We need the details of the treatment or medication for which you are claiming.

How to Submit?

Download the Bankmed App :
** You must submit your claim within four months from the date of service. After this, the claim expires, and you will not be reimbursed.
** Make sure your membership number and the Healthcare Professional’s details, including their practice number, are clear on the claim.

Bankmed website :
** Log in
** Go to Claims and click on Submit a claim
** Once there, go to Upload and click on Upload now
** Select the file you want to upload and then click on Send claim

** Once the claim has been successfully uploaded, you should receive a reference number
** Scan your claim and e-mail it to claims [AT] bankmed.co.za

FAQs

1. Is there a limit on the time I have to submit a claim to Bankmed?
Claims must reach Bankmed within four months of the treatment date otherwise Bankmed will not be liable to provide benefits.

2. What information must appear on a claim?
All claims must be checked for correctness and must be clearly legible.

On receipt of your account from the Healthcare Professional, check that the following information appears on the account
** Your membership number

** Your surname and initials
** The patient’s first name, surname and dependant code
** Name of your Plan type

** The name and practice number of the supplier of the service
** The nature and cost of treatment
** The referring doctor’s practice number on specialist’s accounts

** The tariff code that relates to the healthcare service you received
** The ICD-10 (diagnostic) code that relates to the healthcare service you received
** Proof of payment, if you have paid the account yourself

3. Bankmed sends me claim statements whenever claims have been settled. Do I need to do anything with this?
Checking your claims statement :
Your claims statement is one of the most important documents you will receive from Bankmed. It is as important as your bank statement.

Check your Bankmed statement as carefully as you would your bank account. By doing this, you will help us to detect fraud and to manage your benefits in the most efficient way.

Please check your statement to ensure that
** The claims on the statement are for services that you and/or your registered dependants received

** Bankmed has processed all claims for services rendered to you and your dependants (and that you have submitted all of your claims within four months of the date the service was received)

** The correct dependant code as shown on your membership card is reflected opposite each claim. You can download your claims statement from the website.

If you notice any errors or have a query, please contact Bankmed Customer Services on 0800 BANKMED (0800 226 5633).

Income tax records :
You should keep your claims statements for income tax purposes.