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

Member Queries Process

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MEMBER QUERIES PROCESS

If you have a quesry you may contact POLMED via:

  • Telephone on 0860 765 633
  • Fax on 0860 104 114
  • Email at polmed@medscheme.co.za
  • POLMED Chat (via mobile device): Download the free POLMED Chat app on your device
  • POLMED Chat (via POLMED website): Log in to the Member zone and click on the POLMED Chat icon

NOTE

  • The Administrator has five (5) working days to respond to your query.
  • Always obtain a reference number and name of the agent.
  • It is extremely important that you follow the correct query process in order for us to assist you:
  • Chronic medicine management registration: polmedcmm@medscheme.co.za
  • Prescribed minimum benefit (PMB) registration: polmedapmb@medscheme.co.za
  • Hospital pre-authorisation: polmedauths@medscheme.co.za

POLMED 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.

MEMBER QUERIES (INITIAL QUERY)

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

OPERATING HOURS

The POLMED Client Service Call Centre and regional walk-in branches operate Mondays to Fridays from 7:30 to 17:00 (excluding public holidays). The regional branches also operate on Saturdays from 8:00 to 12:00. Please click here to view the address details of the various regional branches.

COMPLIMENTS AND COMPLAINTS

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

ONLINE/SOCIAL MEDIA COMMENTS AND QUERIES

The Protection of Personal Information (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.

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

CLICK BELOW TO VIEW THE STEP-BY-STEP GUIDE TO 24-HOUR TELEPHONIC SELF-HELP:
Step-by-step guide to 24-hour telephonic self-help service

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