Profmed Medical Aid’s Claims Procedure

Name of the Organization : Profmed Medical Scheme
Type of Facility : Profmed Medical Aid’s Claims Procedure
Head Office : Centurion

Website : https://profmed.co.za/
Payment Run Dates : https://www.southafricain.com/uploads/3111-Run_Dates.pdf

Profmed Medical Aid’s Quick & Easy Claims Procedure

** Profmed medical aid scheme aims to make the claims procedure as user-friendly as possible for its members.
** In most cases claims are submitted electronically by the service provider, i.e. your doctor, dentist, pharmacist, etc.

Related : Profmed Medical Aid Scheme Membership Application : www.southafricain.com/3107.html

** However, you must check all claims submitted on your behalf to ensure that the service has indeed been rendered to you.
** In this way you will notice if there are any inaccurate claims against your benefits.

** If there does appear to be a problem, please contact the service provider and enquire about the claim submitted on your behalf.
** You must then contact Profmed medical aid scheme and point out the irregularities.

Claims procedure for cash or upfront payments :
** with Profmed medical aid scheme

** If, for any reason, you should pay upfront for services covered by your benefits, you can claim this payment back from Profmed. When making the payment to the provider, please remember to obtain a detailed account and receipt for your payment.

** No claim form is required. You can simply scan and e-mail your claims to claims AT profmed.co.za.

Alternatively, you can post your account to :
Profmed Claims Department
Private Bag X1031
Lyttelton
0140.

** Profmed cannot accept responsibility for non-receipt of posted claims.
** Claims must be submitted within four months from the date of service.
** Please note that faxed claims will NOT be accepted. Faxed claims are generally illegible, which leads to claims being paid incorrectly, or not at all.

Payment of claims :
** Claims will be reimbursed to you by means of a direct payment into your bank account.
** Due to fraud, cheques will not be issued. Please provide Profmed with your bank account details, if you have not already done so.

** Claims paid to service providers are paid every second week.
** Cash claims and claims payable to members are paid weekly.
** Click to view the payment-run dates.

About Us :
Profmed is a restricted medical aid scheme that is open to professionals who have obtained a minimum of a four-year degree or equivalent from a technical university offering these individuals exclusive yet affordable medical cover. Profmed’s medical and healthcare benefits, coupled with excellent service and attention to detail, are offered at affordable rates. Low rates are also available to eligible students. Profmed’s vision is to address the healthcare needs of professionals through appropriate and comprehensive benefit design.

FAQ On Profmed Medical Scheme

Frequently Asked Questions FAQ On Profmed Medical Scheme

Q: What is Profmed Medical Scheme?
A: Profmed Medical Scheme is a South African medical aid scheme that provides comprehensive healthcare cover to its members. It caters primarily to professionals in the healthcare, engineering, science, and technology sectors.

Q: What are the benefits of joining Profmed Medical Scheme?
A: The benefits of joining Profmed Medical Scheme include access to comprehensive healthcare cover, affordable premiums, flexible options, and personalized service. Members also have access to a range of value-added services, such as wellness programs, chronic disease management, and 24-hour emergency medical assistance.

Q: What healthcare services are covered by Profmed Medical Scheme?
A: Profmed Medical Scheme covers a wide range of healthcare services, including hospitalization, specialist consultations, prescription medication, diagnostic tests, and chronic disease management. It also provides cover for emergency medical services and emergency medical transportation.