How To Claim

Below is a step by step process on how to make a claim

EMERGENCY ALERT: Go directly to hospital. No pre-authorization needed. Call us within 48 hours at 086 77 000 716

For Urgent & Emergency Care

1

Get Treatment

Go directly to emergency room.

  • Your health comes first
  • Show member card if possible
  • Focus on getting help
2

Notify Us

Call within 48 hours.

  • Report the emergency
  • Provide hospital details
  • Get case number
3

We Handle Claims & Settle Direct

We coordinate directly with the hospital.

  • Direct settlement arranged
  • Documentation handled
  • You focus on recovery

Planned Treatment

For Scheduled Procedures & Hospital Admissions

1

Get Pre-Authorization

Before your procedure

  • Email: callcentre@healthzim.com or Whatsapp: 0772 126 120
  • Include: Membership number
  • All invoices
  • Referral letter
  • Referral letter
  • Scheduled date of treatment/surgery
2

Receive Confirmation

Response from Alliance Health
Team

  • Request for additional information
  • Confirmation of cover Shortfall indicated
3

Get Treatment

Present your details at the facility

  • Show member card
  • Provide authorization number
  • Sign admission forms
4

We Settle Direct

We pay the provider directly

  • Pay only your shortfall (if any)

Plan-Specific Claim Information

Require Assistance towards your Medical Needs?

Client Services Team

  • Client Services Team: +263 86 77 020 406 / 86 77 000 716 / 0772 126 119 / 0772 126 120 / 0778 244 129 / 0772 126 119
  • WhatsApp: +263 772 126 120 (messaging only)
  • Email: callcentre@healthzim.com

Documents You May Need

For Hospital Admission

  • Member card or member number
  • Valid ID document
  • Doctor's admission letter
  • Pre-authorization number

For Specialist Visits

  • GP referral letter
  • Member card
  • Previous test results
  • Medical history if relevant

For Reimbursements

  • Original receipts
  • Completed claim form
  • Doctor's report
  • Proof of payment

Important Reminders

IMPORTANT REMINDERS!

To help ensure your claims are processed smoothly and without delays, please take note of the following key points.

1

Do not sign blank claim forms with service providers under any circumstances.

2

Always attach a copy of the prescription (script) when submitting claim for medication. This will assist in faster and more accurate reimbursement.

3

Ensure that doctor referrals to specialists are attached when submitting specialist claims.

4

Referral letters to specialists are valid for three (3) months from the date of issue. If you require an extension or have any questions, kindly contact our office for guidance.

5

Claims must be submitted within three (3) months from the date the service was rendered. Claims submitted after this period may be declined.

6

Children aged two (2) years old and below, can visit the Paediatrician without the need for a referral letter from a general practitioner (GP).

7

Children above 2 years of age will require a referral letter from their general practitioner to see a Paediatrician, unless if it is an emergency in which case the request will be escalated immediately for approval. Emergency access to Paediatricians will always be available for our young members.

8

Should you have any queries at all, we strongly encourage you to contact our team. We are here to provide the best advice and support throughout your healthcare journey.

Need clarification? Call our Client Services Team at +263 86 77 020 406

Timing Matters

For planned procedures, always get pre-authorization at least 48 hours before. For emergencies, notify us within 48 hours after admission. Late notifications may affect your claim.

Check Your Benefits

Before any treatment, confirm your available benefits and any waiting periods that may apply. Know your coverage limits and any co-payments required.

Keep Records

Always keep copies of all medical documents, receipts and correspondence. Take note of reference numbers and authorization codes for future reference.

We're Here to Help

Should you have any queries, contact our team. We provide the best advice and support throughout your healthcare journey.