Netcare Medical Scheme Complaint
 SUPPLIER |
Netcare Medical Scheme |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | johannesburg | COUNTRY | South Africa |
| TIME / DATE | 15:17 Fri 20 Jan | PERSON RESPONSIBLE | |
| CUSTOMER | ornnessi | View all reports by user |
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| PROBLEM | Billing / Accounts |
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| INCIDENT | Fri 20 Jan | ||
| HEADLINE | confustion |
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| i went to netcare waterfall clinic as an employer of netcare for treatment on 2 jan 2012. i received a statement saying the medical aid had not paid for my treatment. upon calling the medical aid i was informed that i was supposed to get an authorisation. for an out of hospital procedure? so i got the auth from thobeka who i tried to explain to that this was the same as a gp consult and i dd not need authorisation as no procedures were performed and she insisted that i needed the authorisation. i called the accounts at the waterfall clinic and they did not know anything abou that as they were under the impression that the amount must come out of my savings. i called the medical aid again and spoke to sicelo who said i must fax the account and they would look at it for queries. can someone please tell me why its so difficult for that amount to come from my savings which i obviously still have? and why i must be posted from one consultatnt to the other who do not know anything abou the medical aid in question. needless to say that the medical aid administrators have changed and we still dont have the new brochures that tell us of our benefits!!! i pay for this medical aid !!! | |||
| SUPPLIER'S RESPONSE | Netcare Medical Scheme | Time and Date | 16:01:30 | Fri 20 Jan 12 |
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Hello ornnessi, Thank you for bringing your concerns to our attention, kindly note we are currently investigating this and will get back to you shortly. Kind Regards Shantal Eakduth |
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| UPDATED RESPONSE | Netcare Medical Scheme | Time and Date | 12:18:02 | Tue 24 Jan 12 |
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Hello ornnessi, Further to my previous email, kindly note your claim for the treatment noted on your email (2 January 2012) has been processed for payment from the Hospital benefit and not your savings; this will be made directly to the doctor. Kindly note Netcare Medical Scheme has not changed administrators. We have sent out communication to all members with regards to the delay in posting out the 2012 benefit guides; however your 2012 benefit guide has been published on Netcare's internal Intranet for your ease of reference. Kind Regards Priscilla Moodley |
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