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Aneesa A

1 reviews | Active since Jul 2016

15 May 2018, 10:18

CANNOT PROCESS MODIFIERS CORRECTLY FOR IN HOSPITAL EVENTS

My son went in for operation 20 march 2018 and the Orthopedic submitted his account , It is PMB and they still processed the claim wrong , I am waiting on the account to be processed as they omitted modifier and i previously had the same compliant with my PR16 dos 25 10 2018 they assured me that the it will not happen again , that measurements have been put in place so that all modifiers are processed correctly , again TEAM LEADERS say they will be in contact but they just ignore your mails and refuse to see the urgency in this? The kingsbury hospital account dated 25 10 2017 was queried by myself numerously as they processed it wrong irrespective if the 30% c o payment they eventually reprocess it ad turn around and say it is STALE , Really i am running out of patience and medscheme incompetency, send debt letters when their call centre tells you 3 times in differant calls what amount you must pay? is this really how TCF works , I am going to cancel my membership due to lack of competent staff. The person who just puts up a standard company response is wasting my time, I need answers.

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Replies (5)
Bonitas Medical Fund
Bonitas Medical Fund's reply15 May 2018, 16:29
Official

HelloParis42,

Thank you for submitting a comment to us through Hello Peter.

This is to confirm that we have received your comment and that we are currently investigating this matter.

Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.

Kind regards,

Bonitas Team

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Aneesa A's update16 May 2018, 09:42
Reviewer Update
New added problem they cant read,,,, I sent in my cancellation because of terrible service they cant even get that right, I asked please cancel me end of June , they cancel me end of May , please make sure these people correct my termination.
AA
Aneesa A's update21 May 2018, 10:00
Reviewer Update
still waiting so you wont pay it PMB but the tariff code 0051 was not processed this is the 2nd week and no one has bothered to give me proper feedback, i need this claim line reprocessed correctly with this months statement today is the 21 may and im still waiting
Bonitas Medical Fund
Bonitas Medical Fund's reply23 May 2018, 10:27
Official

HelloParis42,

Thank you for submitting a comment to us through Hello Peter.

We confirm that a detailed feedback has been sent to you via Facebook.

We trust that clarified and we thank you for having been our customer.

Kind regards,

Bonitas Team

AA
Aneesa A's update29 May 2018, 14:30
Reviewer Update
No this matter was not sorted out , I need to speak to a claims assessor , The doctor charged R15 331.86 - My medical aid statement only reflects R12 848.66 was charged - I sent in a paper claim and still some person at medscheme cannot see the logic? CODE :0005, r3544.80 PLUS 0051 R3012.24 PLUS 009 R1311.42 MAKES UP r7868.46 WHERE DO YOU SEE THAT ON MY MEDICAL AID STATMENT