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0860 POLMED or 0860 765 633
For More Info contact our Client Service Centre or send us an e-mail. Send us a message

Member Queries Process

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MEMBER QUERIES PROCESS

If you have a query and would like to speak to a POLMED Client Service Call Centre agent you can contact POLMED via telephone on 0860 765 633. Alternatively send your query/application via fax to 0860 104 114 or send an email to polmed@medscheme.co.za

NOTE: The Administrator has five (5) working days to respond to and resolve your initial enquiry. Always obtain a reference number and name of the agent.

It is extremely important that you follow the correct process in order for us to assist you.

MEMBER QUERIES (INITIAL QUERY)
Admin/Managed Care (Clinical)/General Queries

These are queries you raise with the Administrator when you initially experience a problem with or require information with regard to any medical scheme-related matter.

A reference number will automatically be supplied to you when you submit your query via email. Remember to also obtain a reference number and the name of the agent when you report any matter to POLMED’S Client Service Call Centre.

Submit your query to polmed@medscheme.co.za

Provide the following information for the Administrator to investigate your query:

  • Membership number
  • Patient name and surname
  • Dependent code (i.e. 01 – refer to the back of your membership card)
  • Date of service
  • Name of the provider
  • Practice number of the provider
  • Details of enquiry that may further assist POLMED to investigate the matter
  • Supporting documents i.e. invoice / statement / medicine – or medical procedure declined

MEMBER QUERIES ESCALATED

These are queries that serve as a follow up to your first query after you have not received satisfactory feedback/service.

The query received at POLMED will be investigated and feedback will be provided to the member within a minimum of five (5) working days. The number of days depends on the complexity of the enquiry i.e. more information required from the member/provider to resolve the query.

Send an email to polmedhouse@medscheme.co.za

Provide the following details for POLMED to investigate your query:

  • Membership number
  • Patient name and surname
  • Dependent code (i.e. 01 – refer to the back of your membership card)
  • Reference number obtained from the Administrator (you should have requested this when the initial query was raised)
  • Date of initial enquiry
  • Details of the enquiry that may further assist POLMED to investigate the matter

ADDITIONAL POLMED CONTACT DETAILS

CLIENT SERVICE CALL CENTRE AND REGIONAL OFFICES – OPERATING HOURS

The POLMED Client Service Call Centre and Regional Offices operate Mondays to Fridays from 7:30 to 17:00 (excluding public holidays). Please click here to view the address details of the various Regional Offices.

COMPLIMENTS

If you want to submit a compliment about a positive experience that you had with the Scheme, send an email to polmed@medscheme.co.za and include the details of your experience and the name of the agent who assisted you.

ONLINE/SOCIAL MEDIA COMMENTS AND QUERIES

The POPI Act prohibits the Scheme from disclosing any member’s personal information to third parties without a member’s consent. It is for this reason that POLMED cannot communicate with you via any social media platform such as Facebook, Twitter and Instagram or any other social medium.

POLMED further has an agreement with the Administrator whereby we monitor their level of service offered to members. If the formal processes are not followed, it is impossible to monitor or measure these service levels.

CLICK BELOW TO VIEW THE MEMBER QUERY PROCESS:
Member query process

CLICK BELOW TO VIEW THE 24-HOUR SELF-HELP SERVICE PROCESS:
24-hour Self-help service process

CLICK BELOW TO VIEW DETAILS ABOUT MEMBER APPEALS AND DISPUTES:
Member appeals and disputes

CLICK BELOW TO VIEW DETAILS ABOUT MEMBER COMPLAINTS SUBMITTED TO THE COUNCIL FOR MEDICAL SCHEMES (CMS):
Member complaints submitted to CMS