How do I submit a claim to the Scheme?
If you settle the account, please insist on an accurate invoice that reflects your payment. You can send the invoice and your proof of payment to the Administrator by post or email to the address listed below, and you will be reimbursed directly according to your benefits.
Information needed for claims submission
Ensure your claim is valid, you have received the treatment or services you have been charged for and that the following details are correct and complete:
- Full name of main member
- Membership number
- Name of patient (main member or registered dependant)
- Name of provider and practice number
- Treatment date
- Details of the service (tariff code, CPT code and explanation)
- The diagnosis code (ICD-10)
- Proof of payment if you have settled your account.
If any of the above information is not correct or missing, the claim cannot be processed and the Administrator will reject the claim. You might not receive notification if membership could not be verified. Please update your information with your healthcare provider and the Scheme regularly.
Upload: Scan and upload your claims in the member log in area
Email: Scan and email your claim to firstname.lastname@example.org
Post: Send your claims to Anglo Medical Scheme P.O.Box 746, Rivonia, 2128
Fax: Fax your claims to 011 539 1008 (only use fax if you don’t have other communication channels as fax is often not clearly legible which might result in us not being able to process your claim)
Claims drop-off boxes: Drop off your claims in Discovery’s drop off boxes located for your convenience in most pharmacies, medical practices and at Virgin Active and Planet Fitness gyms nationwide
Remember: If your healthcare professional has already submitted the claim, you do not have to send us another copy.