MH
Mahomed H

1 reviews | Active since Feb 2011

27 May 2024, 10:44

Misinformation

Please assist with required information by gap as you have not covered treatment during hospital awaiting your response.

All GapCover® and/or CoPay claims must be accompanied by the following documents: 1. Copy of the hospital account. (Please contact the hospital for a copy.) 2. Copy of the doctor/s account(s). (Please contact the doctor/s for a copy.) 3. Copy of the medical scheme claim statement, reflecting processing and payment of the applicable account/s. 4. Authorisation confirmation from your medical scheme. 5. Copy of the latest (not older than 3 months) medical scheme membership certificate. 6. Should the bank details for payment of claims differ from the debit order bank details, proof of bank details must be provided in the form of a bank statement. NB: Claims must be submitted to GapCover® within 4 months after the scheme payment date. NB: Claims cannot be processed until all the required documents have been received.

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Replies (1)
Genesis Medical Scheme
Genesis Medical Scheme's reply27 May 2024, 12:35
Official
Good day, we have no record of an admission to hospital for the membership provided. We have however, processed a claim for an outpatient CT scan dated 15 May 2024 and processed the benefit accordingly, in terms of the applicable rule. CT scans that do not result in an admission into hospital, are funded from the out -of-hospital scan benefit- 50% of cost further limited to R8 000 per beneficiary per annum. The claims statements will be sent on Friday. Should you need any further assistance, please contact the Scheme on ***or via email to ***