SB
Sharleen B
1 reviews | Active since Aug 2014
13 May 2015, 09:14
Not paying Dr claims
BE CAREFULL!!! they don't send statements and eventually when you get outstanding dr bills and you ask the questions Essential simply sticks to their story ITS A STALE ACCOUNT AND REFUSES TO PAY. So I had Medicross and Dr van Niekerk that is on their panel and was told don't worry we will submit on your behalf and it got delivered by hand and Essential Med has no record of it. they refuse to pay dr account but when threated they paid certain accounts. BE CAREFULL. I'm now sitting with Dr debt of almost R1500 and Essential med has decided to pay the smallest account out of all the accounts submitted - WHOOOHOOO this is what we pay for to make them rich and we suffer
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EssentialMED's replyOfficial
13 May 2015, 15:21Hello sharleenb,
Thank you for bringing your concerning matter to our attention.
The Accounts Manager was in contact with you regarding your above complaint and advised you that the accounts for the service dates 03-09-2014 and 08-11-2014 was paid on the 03-02-2015 and the confirmation of payments for the mentioned accounts have been emailed to you previously to *** as stipulated on your policy.
You were also advised that there was a rejected amount as we are a Medical Health Insurance and we pay out stated benefits and according to our benefits structure and any amount that has been rejected you yourself as client will be liable for.
An email with the confirmation of payments was sent to you again as requested telephonically.
Should you have any further questions please do not hesitate to contact us.
Kind Regards
Thank you for bringing your concerning matter to our attention.
The Accounts Manager was in contact with you regarding your above complaint and advised you that the accounts for the service dates 03-09-2014 and 08-11-2014 was paid on the 03-02-2015 and the confirmation of payments for the mentioned accounts have been emailed to you previously to *** as stipulated on your policy.
You were also advised that there was a rejected amount as we are a Medical Health Insurance and we pay out stated benefits and according to our benefits structure and any amount that has been rejected you yourself as client will be liable for.
An email with the confirmation of payments was sent to you again as requested telephonically.
Should you have any further questions please do not hesitate to contact us.
Kind Regards
EssentialMED's reply13 May 2015, 15:21
Official
Hello sharleenb,
Thank you for bringing your concerning matter to our attention.
The Accounts Manager was in contact with you regarding your above complaint and advised you that the accounts for the service dates 03-09-2014 and 08-11-2014 was paid on the 03-02-2015 and the confirmation of payments for the mentioned accounts have been emailed to you previously to *** as stipulated on your policy.
You were also advised that there was a rejected amount as we are a Medical Health Insurance and we pay out stated benefits and according to our benefits structure and any amount that has been rejected you yourself as client will be liable for.
An email with the confirmation of payments was sent to you again as requested telephonically.
Should you have any further questions please do not hesitate to contact us.
Kind Regards
Thank you for bringing your concerning matter to our attention.
The Accounts Manager was in contact with you regarding your above complaint and advised you that the accounts for the service dates 03-09-2014 and 08-11-2014 was paid on the 03-02-2015 and the confirmation of payments for the mentioned accounts have been emailed to you previously to *** as stipulated on your policy.
You were also advised that there was a rejected amount as we are a Medical Health Insurance and we pay out stated benefits and according to our benefits structure and any amount that has been rejected you yourself as client will be liable for.
An email with the confirmation of payments was sent to you again as requested telephonically.
Should you have any further questions please do not hesitate to contact us.
Kind Regards