MA
Mohammad A

1 reviews | Active since May 2018

29 Aug 2020, 08:46

Emergency room lie

Hi

Regarding the statement that was sent stating I am liable for an amount of +-R4700. This is preposterous.

Nowhere in my medical aid prospectus as a customer does it state that under an emergency situation(PMB) which this was, that I will be liable to pay any amount if I decide to go to a "network" hospital which is Netcare.

This statement stating that it was a non network referral etc is really shocking. I purposefully had to go to a hospital further away as I was sure I would be covered at a netcare hospital in case of an emergency and was assured by nurses that, that was the case. There is something very odd with this scenario.

This will defiently not be something I will accept. Either this matter gets resolved or I will escalate this further and report this to the ombudsmen and leave this ridiculous medical aid.

Never have I ever experienced something this disgusting before. You are blatantly misleading clients. I have no control what doctors are or who they are in an emergency unit at a hospital. I might as well have gone to any hospital disregarding netcare because I am stuck with the bulk of the bill anyway.

This is really the most preposterous thing I have had to deal with from a company that is supposed to be looking after the wellbeing of their paying customers.

0
Replies (2)
Camaf
Camaf's reply31 Aug 2020, 09:42
Official
Good day Mohammad
Thank you for bringing this matter to our attention.

We are in the process of investigating this matter for you and one of our senior consultants will contact you to discuss. 
Kind Regards,
Wentzel MaistryClient Relations Team Leader 
MA
Mohammad A's update08 Sept 2020, 08:51
Reviewer Update
I would like to say thank you to a lady by the name of Lee-Ann. She had called me the same day and was really professional and said she would be dealing with the hospital to make sure the correct things were submitted. She checked in regulary to provide me with updates. Today she called to day that all my claim have been reviewed again and will be paid in full.

Thanks for your service. My faith has been restored.