RS
Renata S
1 reviews | Active since Dec 2022
31 Oct 2024, 09:50
False Adverti*****t- Make absolutely sure you are willing to trust what they are selling
Worst experience ever. FALSE adverti*****t and misrepresentation which lead to my family making decisions based directly thereon. It is widely shared and advertised that ANY hospital is covered. This is in fact not true. Emergency at Zuid Afrikaans and Netcare Unitas was rejected. Be very careful of all the fine print associated with the cover with Essential Med. This hospital cover issue is not our first issue with Essential med, but was definitely the last straw. Other issues include the delay in payment of my maternity payment, which almost resulted in me needing to forfeit my scheduled c-section time slot
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EssentialMED's replyOfficial
31 Oct 2024, 12:59Good day Renata S,
Our pre-authorisation department received a admission request on the 04th of October 2024 for investigative procedures. Regrettably the admission request was declined as we do not cover for any diagnostic procedures.
Should you need any further assistance please do not hesitate to contact us.
Kind regards,
EssentialMED Team
EssentialMED Team
EssentialMED's reply31 Oct 2024, 12:59
Official
Good day Renata S,
Our pre-authorisation department received a admission request on the 04th of October 2024 for investigative procedures. Regrettably the admission request was declined as we do not cover for any diagnostic procedures.
Should you need any further assistance please do not hesitate to contact us.
Kind regards,
EssentialMED Team
EssentialMED Team
RS
Renata S's updateReviewer Update
31 Oct 2024, 13:09Although I do not agree with your terms regarding admission for investigative purposes, I am not disputing admission for investigative purposes herein currently. I am disputing emergency room assistance which was rejected by two hospitals on two different occasions stating that they either do not accept medical insurance or they do not have any contract with EssentialMed.
Emergencies was declined on 24 September and again on 20 October.
Please note a complaint was lodge at The National Financial Ombud Scheme (NFO) as well
Emergencies was declined on 24 September and again on 20 October.
Please note a complaint was lodge at The National Financial Ombud Scheme (NFO) as well
RS
Renata S's update31 Oct 2024, 13:09
Reviewer Update
Although I do not agree with your terms regarding admission for investigative purposes, I am not disputing admission for investigative purposes herein currently. I am disputing emergency room assistance which was rejected by two hospitals on two different occasions stating that they either do not accept medical insurance or they do not have any contract with EssentialMed.
Emergencies was declined on 24 September and again on 20 October.
Please note a complaint was lodge at The National Financial Ombud Scheme (NFO) as well
Emergencies was declined on 24 September and again on 20 October.
Please note a complaint was lodge at The National Financial Ombud Scheme (NFO) as well