Netcare Medical Scheme Complaint
 SUPPLIER |
Netcare Medical Scheme |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | Gauteng | COUNTRY | South Africa |
| TIME / DATE | 20:36 Tue 10 Jan | PERSON RESPONSIBLE | Surgical Advisor |
| CUSTOMER | tangles | View all reports by user |
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| PROBLEM | Feedback / Response |
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| INCIDENT | Tue 10 Jan | ||
| HEADLINE | No Explanation from medical advisor |
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I needed an operation for a hernia repair and sheath reconstruction,I contacted netcare medical aid for autherisation in December 2011 and was told I had to wait until January 2012 as they were going onto a new system bearing in mind my surgery was booked for the 10th January 2012 at Olivedale hospital.From the 3rd January 2012 I repeatedly tried to get auterisation but to no avail as they denied reciept of a motivation letter sent by the surgeon in December. All motivations were resent by the surgeon on the 9th January 2012 I was told autherisation would be given on the morning of surgery. The hospital contacted me at 0755 on the morning of surgery to say that autherisation was granted.I had just finished packing my bag and leaving for hospital when the medical aid called at 0913 to say the procedure was declined no explanation given, As I have been a paying member for 12yrs this is totally unacceptable.Following calls made by the hospital admin and surgeon I was assured that the surgery would go ahead.I was admitted and minutes before surgery a case manager arrived to say medical aid had retracted autherisation no reason given.I have endured a week of **** leading up to this. |
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| SUPPLIER'S RESPONSE | Netcare Medical Scheme | Time and Date | 12:53:58 | Wed 11 Jan 12 |
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Hello tangles, We apologise for any service oriented inconvenince caused, this will be addressed with the respective consultants. Kindly note; as per our telephonic conversation, your authorisation has been rejected in accordance to our clinical protocols. The above has been communicated to you doctor. Kind Regards Priscilla Moodley |
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| UPDATED RESPONSE | Netcare Medical Scheme | Time and Date | 14:19:41 | Wed 11 Jan 12 |
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Hello tangles, We regret any service related concerns caused, this will be addressed with the respective consultants. Kindly note; as per our telephonic conversation, your authorisation has been rejected in accordance to our clinical protocols. The above has been communicated to you doctor. Kind Regards Priscilla Moodley |
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