Not wanting to settle my medical bill and not keeping me in the loop about my query - TERRIBLE SERVICE

I was admitted into Park lane Clinic on the morning of the 1st November 2017 for a laparoscopic procedure. I called Bankmed with all the information necessary to get preauthorisation for the procedure and my hospital stay, I was told all is well after submitting all the ICD-10 codes and procedure codes. I was off work for almost two weeks for recovery, I then returned to work on the 13th November and found an email with my claim statement saying that the Dr was going to be paid R3 479 instead of R14 950 for the procedure. I then immediately called them and was advised that there was a mistake and the claim would be resubmitted and I will be given feedback within two days. I never received any feedback, I had to follow-up again and was then told another story which was “they advised me on the call when I was calling for the pre-auth that they would not pay the full amount” which was news to me.

I then asked for the call recording with the first gentleman that assisted with the pre-auth and also the lady that said there was a problem with the claim and will resubmit it and was told that Discovery was not in a place to forward the calls to me and so I need to go to their Sandton office to listen to their calls as they have some sort of “special” system that does not allow them to send out copies of calls as it’s “confidential information” and all sorts of gibberish stories ( I spoke to Khaya). He then said that he could send a request for a transcript to be forwarded to me as I refused to go to their offices because I’d already taken time off work for my hospital stay and feel that it’s a ridiculous excuse that they cannot assist via email and so forth. I then again had to follow-up regarding the “transcript” and Khaya was nowhere to be found and instead had to be sent an email and when he finally decided to get back to me, he told me some story about having waited for the transcript people and he’ll let me know when they get back to him as they now decided that they will come out with whatever machine that they can use for me to listen to the calls I requested off which I don’t understand how it now miraculously happened after it was “NOT POSSIBLE” when I asked initially.

The part that really irritated me in all of this is :

· the kind of service I am receiving from people that are supposed to “care about your health and manage your health”. · The stories they have when they are supposed to give you proper answers. · They NEVER get back to you as promised and you always have to chase them then you still get excuses when you do. · The lies of how they work and the sudden turnaround when you keep following up and not letting go.

I’m still waiting for a response as I haven’t been contacted regarding the outcome of what the way forward is and also haven’t received the calls that I requested and am being emailed daily by the Doctor requesting the balance which I clearly do not have because had I know of the charges and told upfront by bankmed, I would have planned better for the surgery or just cancelled it completely until I’m ready financially.

I really need your assistance in getting this sorted soonest as the practice will hand me over to their attorneys if there’s no payment made.

Regards

Phumi