PG Group Medical Scheme Claims @

PG Group Medical Scheme – A member must assure that the healthcare providers charge as per the plan rates. Some healthcare providers relinquish their applications directly to the plan, while others favor paying directly to the patient after consultation or treatment. If the payment is made by the patient, The scheme will pay the member based on the approval of the claim. Claims are evaluated for validity using profit edicts. If the claim is real and the advantages have not expired, the amount is paid directly to the member’s bank account. This assessment takes place double a month; Once the evaluation is complete, a claim description is prepared and sent to the member via post or email.

Procedure to PG Group Medical Facility Scheme

  • At first check the doctor’s account/invoice.
    Required Details:
    The member and the patient negotiated
    Register Name in the scheme
    Membership Number
    ICD-10 codes
    Doctor’s work number
    Signed verification of payment
  • Sign the proof of payment and date the claim.
  • Email Details
    Scan or passport size photograph each page, get sure the quality is good. Email On each page separately. No zip files or many attachments will be allowed.
    Post them to the Address Given below.
    Put the documents in an envelope
    PG Group Medical Scheme
    PO Box 2070
  • You also keep a copy of the PG Group Medical Facility Claims. Upon processing the PG Group Medical Facility Scheme Claims, a description will be made and sent via email or post. Approved claims will be returned within 30 days of receipt.
  • The costs are paid to your bank account upon preparing the claims. Accidents & Injuries

100% reimbursement for the cost of accidents and injuries occurring from motor vehicle accidents If related to PMB, even if you are included as a third party, eg. a pedestrian. Members are expected to submit PG Group Medical Scheme Claims to the Road Accident Fund, any amount obtained for medical costs already paid by the plan, Plans are immediately refundable.

The subsequent documents must be presented for your claim to be granted:

  • A police/accident report
  • An accident injury report
  • A signed legal undertaking

Information Regarding Reports on Injuries

Even if you have a secondary injury, you will need to present a report/letter from your healthcare provider describing the cause of the injury. If the damage is serious, you must finish and submit an accident/injury statement ere any claim can be allowed for payment.

PG Group Medical Facilitygives Medical Facility to the pensioners, widows, employees, and families who belongs from PG Group.

PG Group Medical Scheme is obliged to give fair access to the members and avail quality health care at competitive rates in a controlled healthcare environment, backed by efficient administration.

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