Make sure that your claims reach us on or before the last workday of the fourth calendar month after the month in which the service was rendered. If the claim is rejected because of omitted or incorrect information, you have 60 days from the date of rejection to resubmit the claim.
Most healthcare providers submit their claims directly to Medihelp and you need not submit these again. However, you are able to submit claims in the following ways:
|Member secured website||Medihelp member app||Email us|
Use the Medihelp member app (available on iStore, Google
- You remain
responsible to ensureMedihelp receives claims – even those submitted by healthcare providers.
- Check your monthly statements regularly to keep track of your claims.
Required information on claims
Make sure that the following information is available on your claims:
- Membership number
- Name and surname of beneficiary
- ICD-10 codes
- Date on which the service/ procedure was rendered
Medihelp tariff refers to the tariff paid by Medihelp for different medical
Doctors and other service providers may charge tariffs that differ from the Medihelp tariff. If this happens, you’ll have to pay the difference to the service provider.
|Negotiate with your doctor|
Remember that, as with any other service, you may negotiate a discount with the supplier. It is advisable to determine in advance how much the service provider will charge and how much Medihelp will pay for a specific service. By doing so, you can calculate your co-payment (if any) in advance in order to prevent any unexpected medical expenses.