Health Blog
Refunds: What you need to know!
As a member, you can request a refund from the Scheme when you pay a healthcare provider up-front. We pay refunds electronically to you as the principal member. So, you need to make sure that we have your correct banking details to process your refund.
How much time do I have to submit my refund request?
You need to submit the refund request to us within four months from the treatment date.
1. Here is a step-by-step guide on how to submit a refund request to us: First make sure you have the correct refund documentation:
- Proof of payment such as a credit card transaction slip, receipt of payment or a zero-balance statement from the provider specifying transactions.
- Account featuring the following details:
- Your initials, surname and address.
- Your membership number.
- The date, tariff code and detail of the services or supplies you received.
- The name and date of birth of the patient who received the services or supplies.
- Authorisation number, where needed.
- Name and practice number of the healthcare provider.
- Diagnosis/ICD10 code
- Details of the referring doctor, where needed.
2. The next step is to submit a refund request, using any of the following channels:
- E-mail: phclientliaison@platinumhealth.co.za
- Mail: Platinum Health, Private Bag X82081, Rustenburg, 0300
- Face-to-Face: Submit it at a Client Liaison Office near you.
3. Once we receive your refund request, we will process it according to the Medical Scheme Rules, Rates and Tariffs.
4. Once we have processed the refund request, it will be paid.
5. We will then inform you that the refund has been paid via e-mail. You will also receive an SMS notification and a member statement with full payment details.
Please remember if we don’t have your correct contact details on our system, you will not receive these notifications so make sure your contact details are up-to-date!
To make sure we have your correct contact details, please call Client Liaison on 014 590 1700 or 080 000 6942, e-mail: phclientliaison@platinumhealth.co.za They can also help you to update your contact details or answer any questions you may have.