by HSwebmaster | Sep 14, 2021
WHAT ARE MY CHOICES IN 2021?
Medical Schemes continue to find new ways to pass parts of treatment costs on to members. Our recent claims experience also shows a shift towards claims extending beyond the traditional tariff and co-payment shortfalls into hospital sub-limit and oncology shortfall as well as increased instances of members having used “non-network hospitals”, contrary to their particular medical scheme rules, being lumped with 30% of the hospital account.
We obviously want our clients to have the lowest possible risk of being left out of pocket so both the 2021 options cover ALL 4 main categories of shortfalls. The more budget friendly option, COMPACT 300, reimburses these main categories with lower maximum thresholds and excludes some lower frequency events whilst ELITE continues to offer maximum coverage for a slightly higher premium. The latter is therefore our recommended solution.
Claims must be fully complete with all the required documents and emailed to email@example.com before they will be loaded by Stratum into their claims queuing system.
Claims that are submitted without all the requirements results in your claim not passing the initial assessment stage and cause unnecessary delays in finalising your claim.
Once you have all the documents the claim can be sent to firstname.lastname@example.org
Completed Stratum Benefits Claim Form (All required fields need to be completed).
Updated medical aid membership certificate.
Medical Scheme Transaction history/Statement/Remittance Advice. (Please request the latest version directly from your Medical Scheme – this statement reflects the amounts claimed and paid by your Scheme for the Respective Doctor(s)/Specialist(s)
Respective Doctor(s)/Specialist(s) Accounts for which you are claiming
Proof of payment for any of the claimed shortfalls / Co-Payments for which you may have already made payment.
Your Application Form has been downloaded.
Please upload your application along with all your supporting docs here.