When UKZN Medical Scheme Reimburses You Instead of the Provider: What You Need to Know

In certain cases, UKZN Medical Scheme may reimburse you directly for a healthcare service, even though the provider submitted the claim on your behalf. This typically happens when the provider is not part of the Scheme's designated healthcare networks. In these instances, although the Scheme has received and processed the claim, the payment is redirected to you as a member. You are then responsible for using the reimbursed amount to settle the account with the provider.

Why This Is Important

The money deposited into your bank by the UKZN Medical Scheme is specifically allocated to settle your medical bills and is not intended for personal use. Using these funds for any other purpose-regardless of the reason-can lead to serious consequences. For example, your doctor may refer your account to a debt collection agency, as you are responsible to pay the provider.

What You Should Do

  • Pay the doctor promptly once the funds reflect.
  • Keep proof of payment for your records.
  • Communicate clearly with your doctor about payment timelines.
  • Contact the Scheme if you're unsure about the process.
  • Call: 0860 11 33 22
  • Email: service@ukznms.co.za
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