2024 FIRST CHOICE
13
How can I track my claims?
On the website or mobile app, as a member, with your
personal login details and password.
How frequently are claims paid?
In terms of the Medical Schemes Act all claims must
be settled within 30 days of receipt of the claim by
the scheme, unless there are queries on the account
e.g., incomplete information. CAMAF has weekly pay
runs and payment is made directly into the member's
or service provider's bank account and a detailed
remittance advice is sent to you. If you have asked for
electronic communication you will receive notification
when your claim has been received and when it has
been paid.
What do I have to do to ensure that
my claim will be paid in terms of PMB
regulations?
Ensure that your PMB Chronic condition is registered with
the scheme and that you have followed the scheme
requirements in terms of using a Designated Service
Provider (DSP) in the case of medication and adhered
to the formulary / protocol applicable to your chosen
option and that the correct ICD10 code has been
quoted on the account.
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