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Jarine W

1 reviews | Active since May 2012

04 Feb 2019, 10:55

ZERO SERVICE FROM ESSENTIAL MED

On the 26 July 2017 N Muller was sent for Bloodtests at the Dr's offices of the Southlake Medical Centre in Centurion by Dr E Maree. Claim for these bloodtests were submitted to Essential Med on the 26th July 2017 AND 17 October 2017. Claim was declined because statement showed "in hospital". This was queried with Vermaak & Partners after which they advised this is a system generated statement and ALL their statements show as "in hospital". BUT if a test was in fact IN HOSPITAL the statement would have a PRE-AUTH code.

So, when we received another NON-PAYMENT letter from Vermaak and Partners about this claim, we queried it AGAIN with Essential MED. The 1st feedback we received from them was that the claim was only submitted to them in November 2017, which was after the 90-day submission period, therefor the claim was declined. I was speechless when I received this email from EssentialMed (Elize van der Merwe). THEY HAVE NO IDEA WHAT IS GOING ON IN THEIR DEPARTMENT. I received proof of submissions from Vermaak and Partners that showed claim was submitted TWICE within the 90days with NO FEEDBACK from EssentialMed.

I sent the proof of successful submission AND email from Vermaak and Partners to them confirming the tests were NOT done in hospital and received a reply from Elize stating that claim shows "in hospital"and was submitted after 90 days which means claim is stale!

Did they even bother to look at the proof we sent to them? They are so eager to state info is wrong, or they didn't receive the claim in time, and then they don't even BOTHER TO LOOK AT PROOVE? I have never in my life received such bad service from a company as Essential Med, no wonder they have so many complaints. They are extremely good at ignoring questions, shifting blame and delaying feedback.

0
Replies (3)
EssentialMED
EssentialMED's reply04 Feb 2019, 12:00
Official
Good day Jarwes, 

Thank you for bringing the concerning matter to our attention. 

Please accept this as acknowledgement of your complaint. We will be in contact with you regarding the matter once fully investigated.

Kind regards,
Essential Med
JW
Jarine W's update18 Feb 2019, 15:50
Reviewer Update
So ONCE again Essential med MESSED UP! They GOT one thing right! To ONCE AGAIN make a mistake on a refund to be paid back to a client. So we struggled MONTHS with getting a claim paid out. THIS was after sending proof of submissions through 3 times, providing emails, proof of successful submissions etc. AT LAST we got an email stating the 1 amount on the claim would be paid back to us. NO APOLOGY from the NON-EXISTENT client care at Essential MED. So, we submitted a REFUND form, completed with bank details and sent to Radine Beukes on the 5th Feb. Today we followed up with regards to the refund. Proof of refund was sent, BUT GUESS WHAT, THEY USED OLD BANK DETAILS FROM THE CLIENT! WHAT IS THE USE OF COMPLETING A REFUND FORM WITH BANK DETAILS IF THOSE BANK DETAILS ARE NOT USED. I cannot believe that 1 person has to struggle with a company in this manner. Now we'll get a response to say "claim amount paid will take 14 days to reject" and then only they can re-pay the refund. This means the client is ONCE AGAIN being penalised because of the NON-EXISTANT CUSTOMER CARE AT ESSENTIAL MED. HOW MANY MISTAKES CAN ONE COMPANY MAKE???????
JW
Jarine W's update18 Feb 2019, 15:50
Reviewer Update
So ONCE again Essential med MESSED UP! They GOT one thing right! To ONCE AGAIN make a mistake on a refund to be paid back to a client. So we struggled MONTHS with getting a claim paid out. THIS was after sending proof of submissions through 3 times, providing emails, proof of successful submissions etc. AT LAST we got an email stating the 1 amount on the claim would be paid back to us. NO APOLOGY from the NON-EXISTENT client care at Essential MED. So, we submitted a REFUND form, completed with bank details and sent to Radine Beukes on the 5th Feb. Today we followed up with regards to the refund. Proof of refund was sent, BUT GUESS WHAT, THEY USED OLD BANK DETAILS FROM THE CLIENT! WHAT IS THE USE OF COMPLETING A REFUND FORM WITH BANK DETAILS IF THOSE BANK DETAILS ARE NOT USED. I cannot believe that 1 person has to struggle with a company in this manner. Now we'll get a response to say "claim amount paid will take 14 days to reject" and then only they can re-pay the refund. This means the client is ONCE AGAIN being penalised because of the NON-EXISTANT CUSTOMER CARE AT ESSENTIAL MED. HOW MANY MISTAKES CAN ONE COMPANY MAKE???????