MK
Msizi K

1 reviews | Active since Apr 2015

20 Apr 2015, 10:12

Essential Med IGNORES you when you CLAIM!

Hello,<br> <br> I downloaded a List of Dentist Network from the Essential Med website and I chose one Dentist closest to me (Dr. P.A.W. Harmse, in Kempton Park) and I made an appointment to clean my teeth.<br> <br> After they cleaned my teeth, they informed me that they are NO LONGER contracted with Essential Med - and therefore asked that I pay the bill because they can't collect their money from Essential Med.<br> <br> Having paid for the supposedly out-of-network dentist (which I had no knowledge of), I sent an email to Essential Med via their website contact form. 2 days later, I received an email from Ayesha West saying I have to complete the claim form and send it back - I completed the form and sent it back with the invoice from Dr Harmse.<br> <br> On the claim form, there's a line which says \the fund will be paid within 30 days"<br> <br> It's been waaay more than 30 days. And now they're ignoring my follow-up emails. I call the call centre number and it rings non stop.<br> <br> This is NOT right! I want MY MONEY BACK!!"""

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Replies (1)
EssentialMED
EssentialMED's reply02 May 2023, 21:58
Official
Hello MsiziK9207,

Thank you for bringing your concerning matter to our attention.

A manager was in contact with you regarding your complaint whereby you have been informed that on the 04.03.2015 your claim was submitted to us with the detailed account from the practice and the proof of payment. On the 04.03.2015 an email was then sent to you with the reimbur*****t form attached for you to complete and then resubmit to us in order to be reimbursed according to our formulary. There was no follow up from yourself with regards to this claim inquiry since the 04.03.2015. As per the telephonic conversation it was advised that you forward the reimbur*****t form so that your claim can be sent for processing.

Please be advised that for a reimbur*****t to get processed successfully you need to submit a completed reimbur*****t form with the detailed account from the practice and the proof of payment.

Should you have any further questions please do not hesitate to contact any of our friendly consultants who will assist you.

Essential Med strives towards the best service delivery to all our valued clients.\