We understand that the 2022 tax certificates will be available from the middle of this month. These should certainly be ready when the SARS filing season begins on 1 July.
For our Discovery clients we have established that their scheme has had systems issues recently regarding processing certain claims and claims adjustments which have led to unfortunate delays. As an example of this, we established that pap smear claims which are normally paid from the screening and prevention benefit (if in accordance with member’s plan guide) seem to be automatically rejected. This is a system error that the Discovery IT department has been trying to resolve in order to have all affected claims reprocessed correctly. Unfortunately, we have been given no time as to when this is likely to be resolved.
On the GAP side, Stratum is expanding their claims department due to the high volume of claims being submitted in recent months. There have been some delays in claims being resolved due to errors made by newly trained claims assessors; however, Stratum has confirmed that this should be resolved soon, with the relevant department actively managing any issues regarding claims processing. Just another reminder to members that they have 6 months to submit GAP claims from date of service.
When submitting GAP claims always include the following:
- Completed claim form.
- Detailed service provider invoice.
- Medical aid statement.
Please contact Lorraine on 011 656 2910 or admin@maximuswm.co.za for any queries or further information.