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11 views1 page

Legal Document

Legal document

Uploaded by

dmuzvuve17
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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+2638677400500

[email protected]

cimas.co.zw

fb.com/cimasmedicalaid

East Block, Borrowdale Office Park


Together we make a difference P.O. Box 1243, Harare, Zimbabwe

13809471 2024/06/14
MR DZIDZAI MUZVUVE Ref: 37267786
745 ASPINDALE PARK
HARARE

Claims Advice
Option Member Date of payment run
Secure Private 13809471 14/06/2024

See the end section of the statement for a detailed explanation of statement contents and reasons

Claims
Provider: AMIT-CARE RADIOLOGY (15968295 / 1164007)
Treatment Date Item Code Claimed Paid Scheme Savings Member Pay To Refund Reasons
Amount Amount Amount Amount Tax Provider To You
Patient: MR DELROY MUZVUVE
06/05/2024 71020 25.00 25.00 25.00 0.00 0.00 0.00 25.00
Statement Totals 25.00 25.00 25.00 0.00 0.00 0.00 25.00

Member Claim Balances


Opening Balance 0.00
Claims Processed (Refund to you) 25.00
Payment (Ref. 1157742) of 25 paid into account ********0001 on 18/06/2024 -25.00
Closing Balance 0.00

Item(s)
Item Code Description
71020 Chest, routine

Statement columns explained


Column Explanation
Treatment Date Indicates the date of treatment
Item Code Treatment codes (e.g. tariff, nappi) submitted on this claim (including modifier).
Claimed Amount The amount submitted
Paid Amount The amount the system accepted
Scheme Amount The amount paid for by the scheme
Savings Amount The amount paid from savings
Member Tax The Member Tax Amount
Pay To Provider Amount paid to the provider by the scheme
Refund to You Amount refunded to you by the scheme
Reasons A list of reason codes explaining the current balance of the claim

CIMAS MEDICAL AID SOCIETY Page 1 of 1


Bulawayo Gweru Mutare Masvingo
Medical Centre, Cnr J. 23 Sixth Street Cimas House 19 Hofmeyer Street
Tongogara St/ 8th Ave P.O Box 1402 98 Second Street Masvingo
P.O. Box 5 +263 (0254) 222 6178 +263 (20) 677 03 +263 (039) 2264800-2
+263 (029) 648 76

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