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Sirago claim form
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Service provider’s invoice/Doctor’s account
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Hospital bill
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Medical scheme statement
Sirago claim form
Provider’s invoice/Doctor’s accounts
Hospital account
Proof of co-payment and/or medical scheme brochure or marketing material
Detailed medical scheme statement that shows the co-payment applied, reason code and/or explanation for the shortfall
- In the event of a penalty fee co-payment, an authorisation letter from the Medical Scheme
Sirago claim form
Casualty/emergency room account
Service provider’s invoice/Doctor’s account
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Sirago claim form
Casualty/emergency room account
Service Provider’s invoice/Doctor’s account
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Hospital bill
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Treating provider’s invoice
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Medical scheme statement
Sirago claim form
Death certificate
Sirago claim form
Hospital bill if admitted into hospital
Treating provider’s invoice
Medical scheme statement
Authorisation letter confirming internal prosthesis/radiology limit
Sirago claim form
Death certificate or permanent disability report
Monthly medical scheme membership certificate
Completed debit order authority form, if applicable
Sirago claim form
Death certificate or permanent disability report
Monthly medical scheme membership certificate reflecting membership status and monthly contributions
Sirago claim form
Confirmation of oncology programme registration
Treating provider’s invoice
Medical scheme statement
Sirago claim form
Histology report confirming date of diagnosis
Sirago claim form
Provider’s invoice
Medical scheme statement
Sirago claim form
Service provider invoice Police report Report from service provider
Sirago claim form
Facility invoice
Medical scheme statement