Claims Processes

Submitting your claim


We would like to remind you that fax and email claims for refunds or processing are accepted. This change was implemented as part of the Fund's communication strategy, to improve our service delivery for claims submissions.


We continue to strive to improve the quality of our service levels at all times, for all our people.


How to submit your claim:


011 381 2041/2042




Claims Department
PO Box 32931


Avoid stale claims


According to the regulations of the Medical Schemes Act, a claim is stale and will not be processed by the Fund if it is submitted more than four months (120 days) after the date that the service was rendered.


Remember that there is no need to wait until you have many claims before submitting it to the Fund. If claims are held back, it may become stale and result in the non-payment thereof.


Please follow up if the Fund hasn't responded to a claim that was submitted within the last two payment runs, as this would assist in getting it processed before it becomes stale.


Payment of a stale claim will only be considered if there is proof that the claim was indeed submitted to the Fund within four months of the date of service and that you have followed up on the claim with the Fund.


Transmed has two claims runs per month, meaning we pay claims twice a month. This is important for you to know so that you know when to submit claims and expect claims payment. Please always ensure that you quote your membership number when you submit accounts and correspondence to Transmed.