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Claim Optimiser

Medical schemes have co-payments or upfront payments that apply to certain procedures or tests (eg MRI/CT scans) that must be paid by members before undergoing the treatment or tests.

To assist Cinagi members, we have established the Co-Payment Claim Optimiser, where we will guarantee the payment directly with the relevant facility prior to you having the procedure/treatment. This means that you do not need to make any out-of-pocket payments and we will pay the provider directly on your behalf.

Please note that this service is not available if your policy is still subject to a waiting period – kindly read the ‘Important Notes’ below on how and when the Co-Payment Claims Optimiser service can be utilised.

How does it work?

  1. Obtain the pre-authorisation letter sent to you from your medical scheme.
  2. Complete this form at least 72 hours before your admission by clicking on the ‘Next’ button at the bottom of this page.
  3. Fill in the details on the form and upload the above pre-authorisation letter when requested.
  4. Once your request has been reviewed and approved by us, we will provide a payment guarantee to the facility.
  5. You will receive a confirmation letter from us which can be presented to the provider on the day of admission/treatment.


  • The Co-Payment Claim Optimiser is not available if your cover is still within a waiting period.
  • This facility is only applicable to defined co-payments or upfront payments (as per your medical scheme rules) and that are covered in full by your Cinagi Gap Cover policy. Examples are:
    • Radiology (eg, MRI and CT scans)
    • Scopes (eg, gastroscopy, colonoscopy, sigmoidoscopy, proctoscopy, etc)
    • Wisdom teeth extraction
    • Defined Co-payments on specified surgical procedures
  • Any additional shortfalls that arise after your procedure/treatment that are not covered by the Co-Payment Optimiser, will require you to submit a separate claim, you can intiate the claim HERE.
  • By making use of this service you agree to cede to us the benefits relating to co-payments under your Cinagi Policy for this procedure. This only applies to co-payments or upfront payments that have been approved by Cinagi.