Medihelp Complaint
 SUPPLIER |
Medihelp |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | Head Office | COUNTRY | South Africa |
| TIME / DATE | 09:38 Tue 7 Feb | PERSON RESPONSIBLE | |
| CUSTOMER | cbarnold | View all reports by user |
 0
2
|
| PROBLEM | Billing / Accounts |
 Post this report to your Facebook page Post this report to your Twitter page
|
|
| INCIDENT | Mon 6 Feb | ||
| HEADLINE | have never claimed before but its a nightmare |
||
| On 23 February 2012 my doctors advised me that I had to be admitted to hospital. It had already been late in the day and knowing my medical aid, their offices were already closed. Despite knowing this we attempted on several occasions to contact the emergency line only to be answered by Netcare 911, the gentleman at the call centre named "Moosa" was extremely rude and merely responded by saying that he cant help us. I had to pay an amount of R950 (Nine Hundred and Fifty Rand) at the hospital to be admitted. The following day we were advised that the Medical Aid would not pay for my admission as no pre-authorisation was obtained despite this being impossible at that time and despite that fact that it had been an emergency. After I was discharged I was advised by the pharmacist that the Medical Aid would also not pay for my medication and I have now received a bill advising that the specialist who attended to me is now my responsibility despite my plan stating that they would pay for this. I further have to now pay for my chronic medication according to the plan despite the regulations of the Medical Aid Scheme and Prescribed Minimum Benefits. It leaves one thinking whats the point? | |||
| SUPPLIER'S RESPONSE | Medihelp | Time and Date | 08:50:59 | Wed 8 Feb 12 |
|
Hello cbarnold, Thank you for writing to us. Your complaint was referred to our client service department for investigation and a consultant will contact you in this regard. Kind regards Medihelp Customer Care |
|||
| UPDATED RESPONSE | Medihelp | Time and Date | 15:42:08 | Fri 24 Feb 12 |
|
Hello cbarnold, Medihelp liaised with Netcare 911 and according to the information at their disposal; they are unable to trace the telephone conversation between yourself and Moosa from Netcare 911 on 23 January 2012. Upon receipt of your complaint, Netcare 911 attempted to contact you on numerous occasions, in order to establish the specific date and time of your telephone call, but to no avail. Any telephone call received at MSO after-hours is channelled to Netcare 911, for emergency purposes, who will provide the member with a reference number. According to MSO, your spouse contacted them on 24 January 2012 at 09:35 to obtain the necessary authorisation for your hospital admission, but they were unable to so, due the fact that he was not in possession of the relevant ICD-10 codes to enable them to approve your hospitalisation. MSO also received a telephone call from your father on the same day, where after MSO informed him that they require the medical report, which includes the ICD-10 codes, from the treating doctor. This report was only received from Linmed hospital on 25 January 2012, whereby your hospital admission was approved. Kind regards Medihelp Customer Care |
|||
Relevant content (Last 5 Billing / Accounts Problems)
 |
|||
|
|
|||
|
|
|||
 |
|||
 |
Facebook Application
