Worst Experience Ever

I’ve had the worst experience ever. This medical aid gives me headache. They always demanding motivations for almost every claim and most of those claims end up being rejected or not being paid in full. There are still outstanding amounts for certain doctors, hospitals and laboratories. How do you not pay especially for hospital admission and laboratories. No one chooses to be hospitalized, especially after working hours. I was hospitalized after the call centre had closed hence hospital could not get authorization but because I was sick and couldn’t even do anything they admitted me. Then medical aid requires a motivation letter when the claim was being submitted. Even worse they did not pay the admitting doctor. Why don’t you just open the call centre 24/7 so we can know before admission that you won’t pay. Another thing , how do you pay just a doctor and not the laboratories? Doctors use laboratory investigations to confirm their clinical suspicions and also help them guide their management and check improvement. How do you not pay for laboratories like Lancet and Ampath when they are such a crucial part of the management? I’m so disappointed. Now I have a bill of more than R25 000 yet I have a ‘medical aid’. This medical aid is so unfair, people say it’s a ‘****’ and I’m starting to believe that too.