Working together to deliver quality care
Alliance-Midmed works closely with healthcare providers to ensure members receive consistent, high-quality care.
As part of our network, you play an important role in supporting the health and wellbeing of Columbus Steel employees and their families.
We support you with clear processes, efficient administration, and access to a dedicated team that understands the needs of our members.
Benefits of Partnering with Alliance-Midmed
Dedicated support
Direct access to a provider support team for assistance with claims, member eligibility, and queries
Efficient claims processing
A clear and streamlined claims process with reliable turnaround times
Practical tools and resources
Access to provider tools and information to support accurate, efficient patient care
How claims are submitted
In most cases, your healthcare provider will submit claims to the Scheme on your behalf. Over 90% of providers submit claims electronically using EDI (electronic data interchange), either in batches or in real time. Most electronic claims are processed within three days, and payments are made twice a month.
How payments work
If your healthcare provider charges at the Alliance- Midmed Rate and you have not paid them, the Scheme will pay the provider directly. There may be exceptions, such as optical services. If your provider charges above the Scheme rate, you may need to pay the difference. In these cases, your provider can contact us on 0860 002 101 to discuss payment options.
What you need to do
Before receiving treatment:
- Confirm what your healthcare provider will charge
After treatment:
- Pay any required co-payments directly to your provider
- Check your statements carefully
- Report any unusual or incorrect claims
Your responsibility
It is your responsibility to ensure that:
- Claims are submitted correctly
- All claims on your statement are valid
What is required for a claim
For a claim to be processed, the following information is required:
- Membership number
- Surname and initials of the principal member
- Name and date of birth of the dependant (as per your membership card)
- Date of treatment
- Doctor’s valid practice number
- Tariff code and ICD-10 code
- Cost of service (full amount, as split billing is not allowed)
Additional information for medicine claims
Most pharmacies submit claims electronically, so you may not need to provide this.
If required, the following must be included:
- Name of medication
- Quantity or dosage
- NAPPI code
- Referring practice number
The Medicine List Lookup helps you and your healthcare provider find medicines that may reduce or avoid co-payments, helping you keep your out-of-pocket costs lower.
It is especially useful if you take chronic medication every month, as it allows you to check available medicine options and make informed choices about your treatment and costs.
Check the formulary to find medicine options that may help you reduce or avoid co-payments.
What to know about dental claims
Some dental treatments involve work done by a dental technician. The technician charges the dentist, and this cost is included in your claim. To avoid delays, make sure the technician’s invoice is included and complete. Missing details, such as your name or membership information, may result in delays or rejection of the claim.
If you submit claims manually, keep a copy for your records in case the original is lost. If you have already paid. If you have paid the account yourself, please submit:
- The account
- Proof of payment
This is required for the Scheme to process your refund.
To protect our members:
- Payments are not made by cheque
- Bank detail changes are only processed after strict verification
Please ensure that your banking details on record are correct and up to date.
Important Notice
Alliance-Midmed Medical Scheme is a registered medical scheme in
South Africa.
Attention Health Providers:
- We are not affiliated with Allianz Care or Alliance International Medical Services.
- For inquiries, contact Alliance-Midmed at 0860 002 101 or service@alliancemidmed.co.za.
- Send pre-authorisation requests to auths@alliancemidmed.co.za. After-hours membership confirmation is available by calling 0860 002 101. We are working on an after-hours authorisation solution.
For Hospitals:
- Mediclinic hospitals list Alliance-Midmed.
- Netcare hospitals can assist with ‘Midmed’ searches.
AZOZA Available 24/7 at 0860 255 426, offering:
- Medical Ambulance & Evacuation: Emergency response and evacuation anywhere in South Africa.
- Clinical Assessment: Nurse-based triage to identify problems and locate nearby health services.
- Health Counselling: Nurses provide clinical information and guidelines on healthcare
procedures, diagnostic tests, and illness management. - Personal Health Advisor: Guidance on issues like self-treatment and breastfeeding.
- Audio Library: Access to health-related audio recordings.
After-Hours Nurse Support: 082 904 7510
Available for authorisation and hospital admission queries only.