Poor service. faced with a lot of uncovered medical bills

<p>On the 30/09/2016</p> <p>My son was hospitalized with meningitis. He had to stay in hospital for 14 days. The hospital called the medical aid for authorization.</p> <p>In the month of November I received a bill from the pediatrician advising that I owe R15k. with investigation done with the pediatrician I was advised that these are normal PMB rates and the medical aid should cover all amounts.</p> <p>When taking this up with the medical aid, they asked a lot of questions such as why I chose the hospital etc. which I have answered. They came back advising that the full amount will be settled by the 30/11/2016.</p> <p>On the 12/12/2016 I received a statement advising that I owe R12k with the explanation below. (Your email dated 12 December 2016 refers.</p> <p>Kindly be advised that our communication dated 22.11.2016 served to inform you that the claim of Dr MC Greef & Paediatric Associates, for the service date 30.09.2016 was clinically approved to be settled in full. The Scheme settled the rejected portion of R1,986.48 to the provider with our payment run dated 30.11.2016.Our email went onto state that the remaining service dates, i.e. 01.10.2016 – 15.10.2016 has been processed correctly in accordance with the Rules of the Scheme. In other words, no further benefit has been awarded to these service dates. The rejected amount of R12,296.54 is the member’s portion payable, as the fees claimed exceeds the Scheme’s reimbur*****t rate.</p> <p>It was further communicated to you to discuss the outstanding amounts directly with the service provider.</p> <p>Considering the above, the claim of Dr MC Greef & Paediatric Associates has been settled in accordance with the benefit option which you have selected, i.e. Private Choice.</p> <p>We trust that what is said herein is of assistance to you.)</p> <p> </p> <p>This does not make sense, I was never informed that the medical aid will not cover the amount for treatment. Genesis is fast to deduct their monthly premium but not fast to pay the bills. Why have medical aid if you will be having bills after being hospitalized. </p>