How to submit a claim
You can submit your claim in one of these ways:
Tips on submitting a medical claim
Get your claims paid quickly and easily by following these simple steps.
1. Ensure your banking details are correct
Claims refunds are only paid into a bank account by electronic funds transfer (EFT). Please call us on 08080001-3 if you need to update your banking details.
2. Check your claim and receipt
Make sure that your membership details are clearly indicated on both the claim and the receipt. Please ensure that the claim shows the following:
- Your name and initials
- Your membership number
- The treatment date
- Claim signed by member or guardian
- The name of the patient as shown on your membership card
- The amount charged
- The tariff
- Provider details
- Provider stamp and signature
- Referring provider if it is a Specialist claim
For Radiology and Pathology claims, a Doctor’s request form is also required.
For Hospital claims, a breakdown of drugs and sundries given while admitted is also required.
Please check that prescriptions for medicine show all your details and that the correct amount for medicine dispensed is shown on the claim. If the pharmacy omits any of these details, we will not be able to process your claim.
3. Check that your claim has been paid
Cimas claims are processed every two weeks for subscribers, and every month for service providers.
The Cimas App and Web Portal can also help you track your claims.
