General claiming procedure
a) Member fills in claim form on the top red section clearly indicating the following:
- Medical aid name
- Member’s full name
- Member’s physical or postal address
- Name of employer
- Patient’s name, relationship to member, membership number, suffix and date of birth
- Signature of member or dependent or any accompanying relation and the date of signing.
N.B the fee charged can be included if its known by the patient but it is not mandatory.
b) Provider fills in the bottom black section clearly indicating the following:
- Namas number, date on which the claim form was closed (if applicable) and claim reference number (if applicable)
- Name of referring doctor if the provider is not a hospital, clinic or a general practitioner
- Tariff code, modifier (if applicable), quantity, date of treatment and the fee charged
- Total of fee charged
- Diagnosis, if multiple indicate all of them
- Provider should sign and put a date stamp to endorse that all written by the doctor is true.
If the provider requests cash upfront before treatment, still all the above apply except that an original receipt should be attached to the claim form then the member can claim from their medical aid.