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Episodic Insurance Claims: How to claim? 

Pre-authorisation: 086 191 1011Client Services: 021 001 2490Email: [email protected]

Prior to admission Icon

Prior to admission
Present your membership number or card to the hospital. Note that your Episodic policy may be known to the hospitals as “Africa Assist”. The hospital contacts the Essential Med call center on 0861 911 011 to get pre-authorisation.

Acknowledgement Icon

Acknowledgement
You may be asked to sign acknowledgement of the authorisation and cover provided under your benefits.

Admission Icon

Admission
You will be treated at the hospital or casualty ward.

Claim-submission Icon

Claim Submission
The hospital will submit the claims to Essential Med (the administrator) and the providers will be paid directly according to the acknowledged benefits.

Prior to admission Icon

Prior to admission
Present your membership number or card to the provider

Claim-submission Icon

Claim Submission
The provider will submit the claim to Episodic Health or Essential Med

Settlement Icon

Settlement
The providers will be paid directly according to your benefits

Prior to admission Icon

Prior to admission
Present your membership number or card to the provider

Claim-submission Icon

Claim Submission
Submit your claim by filling in the claim form and attaching a detailed account as well as proof of payment to [email protected]

Settlement Icon

Settlement
You will be reimbursed according to your benefits

Prior to admission Icon

Prior to admission
Present your membership number or card to the hospital. Note that your Episodic policy may be known to the hospitals as “Africa Assist”. The hospital contacts the Essential Med call center on 0861 911 011 to get pre-authorisation.

Acknowledgement Icon

Acknowledgement
You may be asked to sign acknowledgement of the authorisation and cover provided under your benefits.

Admission Icon

Admission
You will be treated at the hospital or casualty ward.

Claim-submission Icon

Claim Submission
The hospital will submit the claims to Essential Med (the administrator) and the providers will be paid directly according to the acknowledged benefits.

Prior to admission Icon

Prior to admission
Present your membership number or card to the provider

Claim-submission Icon

Claim Submission
The provider will submit the claim to Episodic Health or Essential Med

Settlement Icon

Settlement
The providers will be paid directly according to your benefits

Prior to admission Icon

Prior to admission
Present your membership number or card to the provider

Claim-submission Icon

Claim Submission
Submit your claim by filling in the claim form and attaching a detailed account as well as proof of payment to clai[email protected]

Settlement Icon

Settlement
You will be reimbursed according to your benefits