2025 MEMBER GUIDE - NETWORK CHOICE
15
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2025
MEMBER GUIDE - ESSENTIAL PLUS & ESSENTIAL NETWORK
15
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 SMS 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 is paid in terms of PMB
regulations?
Ensure that your PMB 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
• correct ICD10 code has been quoted on the
account.
