Name of the Organization : LMS Medical Fund
Type of Facility : LMS Medical Fund Claim Process
Head Office : Pinelands
Website : http://www.lmsmedfund.co.za/claimsGuideline : https://www.southafricain.com/uploads/2533-LMS-How-to-Claim.pdf
LMS Medical Fund Claim Process :
How to claim :
** Most service providers have the ability to send claims electronically, ensuring a very short processing time.
** Alternatively, you can submit your claim via email to lms.claims AT medscheme.co.za or post your claim to PO Box 38632, Pinelands, 7430.
Related : Medshield Family Medical Aid Scheme Claim Process : www.southafricain.com/2530.html
** If you’re a member on the TRADITIONAL Standard option choice, you can email your claim to lms AT carecross.co.za or post your claim to P.O. Box 44991, Claremont, 7735.
** If your healthcare provider has claimed electronically and you receive a copy of the claim (for your information), you do not need to send a copy of the claim to the Scheme.
Information That Must Be On The Claim :
** The claim must also be clear, detailed and easy to read.
It must include :
** The correct membership number
** Member’s last name and initials
** Full name of the patient
** Date of birth of the patient
** The correct dependant code
** The date of service
** Treatment code (Tariff/Nappi)
** The amount charged
** ICD-10 code on every item listed on the claim
** The service provider’s name and practice number
When Submitting Claims :
** It is your responsibility to ensure claims are submitted for payment, to get a copy of the claim (even when the service provider submits directly to the Scheme), and to check your account compared to the services you received.
** If you have settled the account, please submit proof of payment in the form of a receipt or proof of Electronic Funds Transfer (EFT)*.
** Make a copy of the documents for your own records.
** * The only document we will accept as proof of payment is a receipt or proof of EFT payment.
** A written note indicating ‘paid by member’ or a ‘paid’ stamp will no longer be accepted.
** If the correct proof of payment is not attached, the account will be rejected.
Contact Address :
LMS Medical Fund
PO Box 38632
Pinelands
7430