KlerksdorpPO Box 10710, Klerksdorp, 2571 - 145 Dr Yusuf Dadoo Avenue, La Hoff, Klerksdorp, 2570

Tel nr: 018 468 7402, Fax nr: 018 468 8153, E-mail: cmacnoordwes@mweb.co.za / cmacnw@mweb.co.zaFSP nr: 47048

Dr Pikkie Kok & Ina Kok

2017

Die volgende prosedure moet gevolg word om die eis volledig te kan indien:  STRATUM GAP COVER: SUBMITTING FULLY COMPLETED 2017 CLIENT CLAIM FORMS   IMPORTANT TO NOTE  ·          Please submit 2017 business forms only ·          Submit a Client Claim Form only when all the supporting documents are available. Where

you await copies of service providers’ accounts or medical scheme claims remittance statements it should be submitted when you are in possession of all the relevant documents – ALL Dr’s statements, Receipts (when you have already paid the provider), Hospital admission form, Medical Aid statements, Medical Aid membership certificate

·          Incomplete forms will be regarded as non-submissions ·          Outstanding information must be completed on the claim form and be

resubmitted. The resubmission goes back into the que as a first time submission ·          Our turnaround time becomes effective from the date the completed claim

form together with the relevant supporting documentation, is received in one submission email

·          We do require your client’s most recent medical scheme membership certificate with each and every claim submission

·          Successfully submitted claims are processed within 5 - 7 working days WHY DO WE REQUIRE A MEDICAL SCHEME MEMBERSHIP CERTIFICATE WITH CLAIM

SUBMISSIONS? We cover the main member, their spouse & all child and adult dependants that are registered

on a medical scheme membership. Where the main member and their spouse belong to two different medical schemes or belong to one medical scheme but on two different medical scheme options, one gap cover policy will provide cover to all of the aforementioned individuals.

However, at the time that a child dependant no longer enjoys cover on either parent’s medical scheme option, we require the child dependant to apply for cover and become the principal insured person on their own gap cover policy.

Cover is verified at claim stage because a status change to the medical scheme membership could have occurred in the interim, which cannot necessarily be verified at application stage.

Yourtrade 269 CC t/a CMAC Klerksdorp – FSP 47048