JR
Jan R

1 reviews | Active since Feb 2014

09 Jan 2020, 15:13

Incorrect supplier medical claim

I hereby would like to express my utterly disappointment of the office's/ accounts department of Botes CJ & Associates Physiothe******s. On 30 May 2019 I had an appointment with said the******s which were for 1 session only. My medical scheme (out of hospital benefits for 2019) in conjunction with my medical package as well as several conversations with my medical aid confirm/describe that you have to had sufficient funds per member per year accordingly, which were all verify and in place at the time. On 8 January 2020 I received an account from the accounts division of Botes CJ & Associates for the settlement of applicable account. My medical scheme had supposedly rejected the claim due to reason "Incorrect/No referring provider populated on claim" which comes down to After investigation from myself that on the original claim it stipulate that they made a referral on referral on the existing claim, and then for that reason my Claim we're rejected due to incorrect administration/documentation submitted by Associates to my medical aid, whereby their were sufficient funds available for the specific prosedure at the time of the claim. Due to another person's error on claim I now have to be held responsible for payment.

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