Virtual_Claim

Step 1 of 9

Gap Cover - Virtual Claim Submission
With the Cinagi Virtual Claim submission you are able to schedule a video call at a time most convenient for you with one of our consultants who will then guide you through the process and providing assistance where necessary.

Before you schedule a slot, we will ask you a few personal details and information relating to your claim. This will allow our consultants to do a pre-claim assessment of your claim and provide feedback during your scheduled time.

Please make sure the below document sare uploaded as they will be required to compile the pre-claim assessment :
- The relevant account from the doctor/provider
- The claims statement from the medical scheme showing how they have processed and paid the above account
- The first 2-3 pages of the hospital account showing the admission/discharge dates, ICD-10 codes, patient name, etc (if applicable)

Document Upload
Upload the accounts from the various Doctors and/or Service Providers(Required)
Drop files here or

Max. file size: 10 MB, Max. files: 15.
The claims remittance from your medical scheme

This needs to show how they have processed and paid the above doctor’s account.

This is also called the ‘claims transaction history report’ which can be downloaded by logging into your medical scheme portal and then clicking on ‘your medical claims’.
To view an example of the Fedhealth Member Statement click HERE.
Gap Cover Claim Documents for Discovery Health Members
Please note that we cannot use the summarised statement that gets automatically e-mailed to you for processing gap cover claims. Please follow the following quick steps to download the correct document required for submitting your gap cover claim:

Step 1: Go to: https://www.discovery.co.za/portal/index.jsp and login using your username and password.

Step 2: On the top menu bar, select “MEDICAL AID”.

Step 3: At the bottom left in the drop down menu, click on “Medical Claims”.

Step 4: Click on the 3rd block that reads “Download a claims document”.

Step 5: Click on the 2nd option on the right that reads “Claims transaction history”.

Step 6: Once selected you can specify the date range in the “Transaction history criteria ” section. This range will need to include the date of when your procedure/treatment occurred.

Step 7: Once you have entered the correct dates, select “Show the results in a printable and downloadable PDF document” and then click Submit.

Your browser will then download a PDF document which you can upload to us in order to process your gap cover claim.

To view an example of the Discovery Health Claims Transaction History Report click HERE.
Upload Medical Scheme Remittance(Required)
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, tif, Max. file size: 3 MB, Max. files: 3.

Declaration & Submission
By providing the information in this form you agree that Cinagi (Pty) Ltd and its underwriter, Infiniti Insurance Ltd may :

To use this information to provide you with administrative and insurance services.

To negotiate with any of my medical service providers on the fees that they have charged.

To disclose this information to persons and entities that it is necessary to disclose this information to in order to provide you with the aforementioned services.

To communicate with you electronically about any changes or general information relating to administrative processes or changes to your policy benefits and premiums or new/upgraded services or products that are available.

To only transfer your personal information outside South Africa if you have provided an email address that is hosted outside South Africa or to administer certain services, for example, cloud services and/or the Medical Second Opinion service.

To obtain any medical records, medical claims or personal information for myself or my dependants from my/our medical scheme and/or my/our medical service providers, including their sub-contractors who process or transfer the relevant medical records, medical claims and personal information between your medical scheme and your medical service providers

To obtain any medical records, medical claims or personal information for myself or my dependants from any medical data bureau or credit bureau who respectively act as aggregators of medical and credit information

You further agree that:

that all details above as well as any supporting documentation supplied with this claim, are true and correct and that you are aware that any non-disclosure or misrepresentation of any details may result in this claim being rejected or your policy cancelled or voided from inception.

•by submitting your dependents’ personal information, you hereby confirm that you are authorised to share such information with us. We will furthermore process their information for the purposes and in the manner as set out in our Privacy Statement

if you are submitting this claim for a person under the age of 18 years (a minor), you confirm that you are a competent person and that you have the authority act on their behalf.

You also acknowledge that that you have read and agreed to the Cinagi Privacy Statement and the contents thereof.

(Required)
I hereby acknowledge and agree to the above:
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Lastly
Before you submit your details, please select a suitable time for one of our consultants to setup a Microsoft Teams Meeting to go though the claiming process with you.

Please click the button below

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Step 1 of 9

Gap Cover - Virtual Claim Submission

Policy Holder Details

Patient Details

Details of Medical Service Providers

Document Upload

The claims remittance from your medical scheme

Additional Documentation

Payment Details