1 reviews | Active since Jul 2013
MISLEADING CLIENTS ON TELEPHONE
I have been with essential med last year and terminated with them on the 31st of July 2019 ,however I had a claim on the 8th July 2019 for an x-ray for my knee ,prior to going for this X-ray I called in first to find out if this was covered because essential med works on formulary for everything including x-rays I spoke to RADINE BEUKES and she confirmed that my knee x-ray was covered as per my telephonic conversation with her with that confirmation I went to the radiology department to have an x-ray the department called to confirm that this indeed covered and then went through with the xray ,the accounts tried to submit the claim on the 8th and the 15th July 2019 with no response from Essential Med ,then they submitted again with a response saying that I terminated my membership on the 31 July 2019 and that the code submitted does not cover my claim what a load of ****!!!!after me calling in and confirming the cover then Radine says that the code that was submitted does not cover on my plan type ??according to me they did 1 or two view BLACK AND WHITE which forms part of the formulary and now I am liable for this account because ESSENTIAL MED didn't cover as far as I am concerned that I was within my period of cover this claim was on the 8th July 2019 I cancelled cover on the 31st July I am well within my period and the x-ray was part of the formulary the x-ray department even corrected the code I am willing to take this further to the Council for misleading information on the telephone if this is not sorted out as soon as possible...POLICY NUMBER-E102859
