1 reviews | Active since Jan 2013
UNAUTHORIZED SERVICES BY Eira Hadebe Incorporated
My elderly parents are on my medical aid since the past 6 years. It is used within the limits of the medical aid, and if there are shortfall amounts, then their GAP cover steps in ONLY if medical aid has authorized and hasnt covered the full amount. In OCT 2023, my mum went for a Hysterectomy. Medical aid declined auth with the physiotherapy as this was a Laparoscopic procedure.
Naturally no services should be rendered with any written consent or payment guarantee.
At no point did the physiothe****** contact me in OCT 2023 to say it was declined and just proceeded to conduct therapy on my elderly mum without confirmation from anyone. DEC 2023 only then did Eira Hadebe Incorporated contacted me in saying i am liable for the bill. I naturally asked what bill? why was i NOT contacted initialy when this was declined in OCT 2023? Yolande and Monique from Eira Hadebe Incorporated said they will contact medical aid again and get auth.
They then respond in telling me that medical aid declined due to depletion of funds. Initially the reason they gave me was "due to reason of admission"
They were now providing contradictory information. I contacted out GAP cover and they oo advised that as long as medical aid did not covered this service, they cannot pay this out.
I then contacted medical aid, and they too verified that 19OCT Tania from Eira Hadebe Incorporated practice had called to get auth for physio and she was fully aware that it was declining as physio is not covered for Laparoscopic procedures.
No physio was required and Eira Hadebe Incorporated was fully aware of this BUT at no point contact me, the account holder to verify payment prior to services being rendered.
I was still not contacted by Eira Hadebe Incorporated practice prior to the declining of auth, I was only contacted AFTER no funds received even though Eira Hadebe Incorporated was fully aware hey will not be paid in regards to this matter. I asked why was physio done when there was no formal written authorisation from any party? Their response was that ït was hand written in the file by physio that my mum gave verbal consent." My mum denies she gave any consent.
Furthermore, no written consent from myself, how can I liable for services rendered due to not notifying the account holder?
This is such ********* practice on Eira Hadebe Incorporated part.
Will a doctor perform any procedure without auth or payment? NO Can you buy food or clothing without cash payment or credit auth prior to purchase? NO
I have now been handed over to Debt collectors, even though this is no fault of mine, to settle this unauthorized bill.
How is this fair?
I trust someone of common sense will contact me in rectifying this ********* practice.
Thank you.
