CLAIMSMART
We help South Africans with medical aid claims, rejected claims, chronic medication applications, PMB applications, authorisations, benefit queries and GAP cover claims — so you spend less time fighting the paperwork and more time focusing on what matters.
Rejected claims.
Benefits exceeded.
Provider not paid.
Unused benefits.
HOW CAN WE HELP?
From everyday medical aid claims to chronic medication, PMB and authorisation queries, we help you understand what is happening and what to do next.
Claim submission, tracking and follow-up support to help keep your claims moving.
Understand your available benefits and make more informed use of your medical aid.
We help you understand rejections and work through the next steps.
Guidance with chronic medication, PMB, oncology and other medical aid authorisation processes.
Support with special medical aid benefits such as nappies, wheelchairs, oxygen, catheters, stoma supplies and other eligible needs.
Help understanding hospital or specialist shortfalls and navigating GAP cover claims.
Medical aid administration does not always fit neatly into one category. We can also assist with resubmissions, extended medicine supply requests, benefit queries, provider follow-ups and other complicated medical aid administration. If you do not see your problem listed, ask us.
Not sure which service you need? That's okay. We're happy to help you work it out.
Get HelpHOW IT WORKS
You bring us the problem. We help you work through what comes next.
Phone, WhatsApp, email or visit us in person. Tell us what you need help with.
We look at the information available and help identify the next step.
Where applicable, we help with submissions, follow-ups and the admin involved.
Know what has been done, what happens next and where you stand.
MEET CLAIMSMART
CO-FOUNDER
Karen brings practical experience and a people-first approach to helping clients navigate their medical aid needs.
CO-FOUNDER
Charlene combines pharmacy and financial management experience with a passion for making medical aid administration easier to understand.
IS THIS YOU?
Whether you need help with a rejected claim, chronic medication, PMB application, benefits, an authorisation or GAP cover claim, we're here to help you work out what comes next.
WHO WE HELP
Individuals, families, chronic patients, oncology patients, caregivers, pensioners and medical aid members.
Explore the Help Centre →QUICK ANSWERS
Find answers to common questions about claims, benefits, authorisations and getting started.
Get Your Questions Answered →CLIENT FEEDBACK
We are building our client feedback library. Real verified reviews will be added here as ClaimSmart grows.
Your experience matters to us. This space will feature verified client feedback.
ClaimSmart client
We want to make medical aid support feel simpler, clearer and more personal.
ClaimSmart client
Have we helped you? We would love to hear about your experience.
ClaimSmart client
LET’S TALK
Tell us what you are trying to sort out and we’ll help you understand where to start. Based in Knysna, we assist clients across the Garden Route and throughout South Africa.
