How to Submit a Claim to Gems

Do you wish to learn how to submit a claim to Gems? Gems is the Government Employee Medical Scheme. It’s the scheme that provides health care to qualifying public service employees. You are here because you are a member and you are looking for information on how you can claim after getting treatment. What are the steps that you need to take to do so. The following is what you need to do;

How to claim from Gems medical aid

The following is how to submit a claim to Gems;

1. You can submit your Gems claim via post to, Private Bag X782, Cape Town, 8000.
2. Another option is to submit via fax to 0861 00 4367.
3. It’s also possible to make your submission via email to enquiries@gems.gov.za.
4. You can also go to your Gems walk-in centre where you can submit your claim.

What do I need to include in my Gems claim?

That’s how to submit a claim to Gem. But what information do you need to include when making your submission? The following are some of the things that you need to include for your claim to be processed as quickly as is possible;

• Your Gems membership number.
• The scheme for which you have signed up.
• Your Surname and Name.
• The name of the patient and their beneficiary code. You can get this on your membership card.
• Name and practice number of the place where you were treated.
• Date of treatement.
• Proof of payment to the medical services provider. This can be in the form of a receipt or an EFT receipt.
• Tariff code.
• The ICD-10 code.
• Your banking details also need to be included in your claim. That includes your account number, the bank’s name and branch code and the account holder’s name.
• Your signature.

What happens after I have made my submission?

Those are the things that you include in your Gems claim. You need to make sure that all the relevant information is provided if you wish to have your application submitted as quickly as is possible.

But how will you know about progress regarding your claim? Gems will send you text messages as they are processing your claim. You can sign up for these by calling 0860 00 4367.

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Summary

In this article, we showed you how to submit a claim to Gems. Gems is the biggest medical aide services provider for civil servants in South Africa. Making a claim is easy, and you can do it via post, through fax or using email.

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