Claims

How to Claim

AGS Health have established several ways in which a member can claim to ensure that doing business with us is hassle free. A client can use the following methods to claim on benefits:

For Day-to-Day claims:

– Members can submit the invoice to claim against a benefit to AGS Offices via fax, e-mail or postal services. You will be reimbursed with-in 72 Hrs. Should you not have funds available, please contact our offices on 010 140 1516 and arrange with one of our claims consultants to make funds available to you. Note that we will then require the statement to be sent to us once you have been seen to.

For Hospital and Accidental claims:

– A member may call our 24-hour service centre at Africa Assist on 0861 333 621
– Africa Assist will grant authorisation and guide them to the nearest medical centre   for the treatment.
– Africa Assist will further grant guarantees to the hospital for a member to be   admitted.
– The member’s account will be managed by Africa Assist and bills will be settled by the insurer.

For Dentistry claims:

– A member may call or email our service provider, Dental Risk Underwriting Managers (DRUM).
– DRUM will provide members with authorisation on procedures where necessary.
– DRUM will administer claims on benefits for member.
– Members may send their claims to DRUM via fax, email or postal services.

– Claims department and Pre-authorisation: 0861 372 343 or 012 741 5101
– Claims Submission and Policy customer Care: smile@dentalrisk.co.za
– Pre-authorisation: auth@dentalrisk.com

AGS Health Offices – (Claims/Complaints)

– Email: claims@agshealth.co.za

– Tel: 010 140 1516
– Fax: 086 605 2345
– Postal Address:
Rock Cottage Office Park
Unit 4B
Cnr Christiaan de Wet & John Voster
Weltevredenpark, JHB

Each member will receive a membership card as well as a policy document.