1 reviews | Active since Aug 2016
Stay away at the cost of paying your own bills
<p>Admitted to hospital. Possible stroke or heart attack</p> <p>Xrays taken of chest</p> <p>Ecg also done </p> <p>They not as admission states admitted for head problems</p> <p>When you have a heart attack or stroke it comes as a result of the heart arteries</p> <p>Gave doctor motivation , still not paying</p> <p>This medical aid should make their auditors go work in hospitals </p> <p>Ilam sure the population will decrease, which is what it seems they want</p> <p>Remember if you admitted for leg injury and have heart attack they will not pay for heart attack</p>
Dear Ashley
We will look into your complaint and revert back soonest.
Yours sincerely
GENESIS MEDICAL SCHEME
Dear Ashley
We will look into your complaint and revert back soonest.
Yours sincerely
GENESIS MEDICAL SCHEME
Dear Ashley
As we explained to you yesterday, the Scheme makes funding decisions based on the information we receive from the hospital. In many instances, as in your case, the information in terms of a diagnosis code(s) and treatment protocols, was very limited.
Representatives of Genesis are not present in hospital and we are not fami**** with the exact circumstances surrounding the admission and the treatment that our members receive. If we then receive claims that are not related to the reason for an admission, according to the information available to us, then claims related to “other” diagnostic tests, examinations, treatment, or incidental findings, which can at face value not be clinically related to our records on your admission details, will be rejected.
As you know, we are not at liberty to discuss any of your confidential information on a public forum, but to demonstrate this with a practical example, we will not fund in-hospital X-rays relating to back problems, if a member was admitted for a tonsillectomy.
We do apologise for not approving certain of your claims when you initially enquired about it. These kind of enquiries can sometimes take time to reassess and resolve, as we rely on the turnaround time of the hospital and / or your treating doctors when additional information is requested. Sometimes they respond immediately, but other enquiries may take longer before feedback is received.
We do trust that you are satisfied with the Scheme’s reassessment decision on your claims.
Should you have any further queries, please contact us on ***.
Yours sincerely
GENESIS MEDICAL SCHEME
Dear Ashley
As we explained to you yesterday, the Scheme makes funding decisions based on the information we receive from the hospital. In many instances, as in your case, the information in terms of a diagnosis code(s) and treatment protocols, was very limited.
Representatives of Genesis are not present in hospital and we are not fami**** with the exact circumstances surrounding the admission and the treatment that our members receive. If we then receive claims that are not related to the reason for an admission, according to the information available to us, then claims related to “other” diagnostic tests, examinations, treatment, or incidental findings, which can at face value not be clinically related to our records on your admission details, will be rejected.
As you know, we are not at liberty to discuss any of your confidential information on a public forum, but to demonstrate this with a practical example, we will not fund in-hospital X-rays relating to back problems, if a member was admitted for a tonsillectomy.
We do apologise for not approving certain of your claims when you initially enquired about it. These kind of enquiries can sometimes take time to reassess and resolve, as we rely on the turnaround time of the hospital and / or your treating doctors when additional information is requested. Sometimes they respond immediately, but other enquiries may take longer before feedback is received.
We do trust that you are satisfied with the Scheme’s reassessment decision on your claims.
Should you have any further queries, please contact us on ***.
Yours sincerely
GENESIS MEDICAL SCHEME