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Chrisna B

1 reviews | Active since Mar 2019

24 Feb 2023, 15:45

Gatvol

Blerrie klomp *****s. Hulle sê hulle dek 1 member elke 24 maande vir 1 oogtoets, 1 PMB raam en 1 stel standard single vision of bio focal lenses. Het nou gegaan en daar is bybetaling op die raam en die lense. Blykbaar dek hul nie n hardner wat in die lens kom om dit te maak nie. En dan as hul sien hulle is verkeerd moet jy met hulle oog afdeling praat maar hulle kan jou nie die nommer gee of deursit nie. Moet NIE hulle gebruik nie. Hulle is baie misleading.

0
Replies (9)
Getsavvi Health
Getsavvi Health's reply24 Feb 2023, 16:02
Official
 Good day  Chrisna

We hereby confirm receipt of your complaint 

Kindly note, the matter is currently being investigated and feedback will be provided soon.

Regards
Lesley on behalf of GetSavvi Health    
Getsavvi Health
Getsavvi Health's reply27 Feb 2023, 10:35
Official
Good day Chrisna 

Kindly note, GetSavvi Health provides cover for Optometry, once per family member in a two year period. Members have access to a consultation, a set of single vision, bi-focal or mutli-focal lenses and a PPN frame. 

Any additional tints or hardening does not form part of the benefit. Should a member select a frame other than a PPN frame, the member will be liable for the frame or shortpayment thereof including any additional tints or hardening. 

According to the Optometry claim received a total of R2049 , the Optometrist provided a discount of R275 and an amount of R1425 was approved and paid, leaving an amount of R349 due by the member. 

We trust you find the above in order. 

Regards
Siddeeq on behalf of GetSavvi Health 
CB
Chrisna B's update27 Feb 2023, 12:02
Reviewer Update
Thank you for your response, however I am still not happy with the outcome.

Let's have a look at our agreement:

9.1.3 Top-up benefits include:
9.1.3.1 One consultation (including eye test)
9.1.3.2 One PPN frame
9.1.3.3 One pair of single vision/bifocal lenses

Now - when my husband went for his eye test at Spec Savers Pretoria North he chose a PPN frame and he asked for standard
lenses... no extras.

Spec Savers told us there will be an excess on the PPN frame and they told us there will be an excess on the hardener they use to make the lens. I told them
I only want what GetSavvi covers, I know GetSavvi don't cover enhancements so don't put hardner in the lenses and they told me, and I quote: "It is impossible to make the lenses without the hardener".

Now I want you to explain to me :
1. If you cover PPN frames - why is there an excess on the frame ? &
2. If "It is impossible to make the lenses without the hardener" and you don't cover the hardener that must come in the lens to be able to make it - How can you
say you cover one pair of single or bifocal lenses ?

I am no expert in making lenses - but either Getsavvi is guilty of false advertising or Spec-savers is lying about the necessity of hardener in the lenses.

All I know is that the one eye test, PPN frame and pair of Single/bifocal lenses that I was supposed to get as per
agreement was not met and for some reason you are trying to make me out as the idiot in the story.


Getsavvi Health
Getsavvi Health's reply27 Feb 2023, 13:10
Official
Good day Chrisna 

Thank you for the feedback received 

The matter was escalated to our Optometry Administrators on Friday 24-02-2023 and feedback was provided this morning in which you have been included. 

According to the provider, you were advised of the extra charge involved when including hardener and a 50% discount was provided for this, the provider has now also advised that the additional cost of R74 for the lenses has been removed as well and you will therefore not be liable for this. 

Therefore the only amount due by yourself will be R275 for lense hardener which GetSavvi Health does not provide cover for, but does increase the lifespan of your spectacles by increasing resistance to scratching and cracking. 

We have also queried with our Administrators if the hardener is compulsory and if the Optometrist made it seem compulsory, as far as we are aware this should not be the case and it should remain the members choice to have this added at an additional cost. 

Regards
Siddeeq on behalf of GetSavvi Health


CB
Chrisna B's update27 Feb 2023, 15:20
Reviewer Update
Siddeeq,

Yes - the provider did inform me that you don't pay the hardener necessary to produce the lens - Please read my previous reply to you - it seems we are moving in circles again.

They did offer me a discount as well...... on a Frame and lens you were supposed to pay 100% of... so they were actually nice enough to give YOU the discount as I wasn't supposed to pay anything to start with.

The hardener is necessary to produce the lens - without the hardener there is NO LENS !!!!

- Why were there a excess on the frame by the way - and what happened to that ?

I don't know how lenses are made

I just spoke to Spec Savers Pretoria North AGAIN and they confirmed AGAIN that the lens can not be made without the hardener. They will have their lab send us both a report relating to the necessity of the hardener in order to produce a lens.

I can understand that other GetSavvi members.. and I suppose other medical aid members as well will shut up and just pay the excess.... but this is unacceptable. If I am sold a service I expect to get what I paid for. Now I need to educate myself in the art of making lenses to fight for what is lawfully due to me...... I promise you, I'm not going to drop this issue.

Getsavvi Health
Getsavvi Health's reply28 Feb 2023, 12:03
Official
Good day Chrisna 

We have provided your feedback to our Administrators to establish whether the hardener in question is indeed compulsory in order to produce the lenses as according to our claims history there are claims where the same lenses were used without any hardener being claimed. This could mean that the lenses were made without hardener or the specific Optometrists might not have charged for it. 

As per our Policy document, the below is stated on page 50 which states that any lens enhancements (including but not limited to) are excluded from the benefit 

9.1.4 Please note that GetSavvi Health does not cover any of the following:
9.1.4.1 Contact lenses
9.1.4.2 Non-PPN frames
9.1.4.3 Lens enhancements including, but not limited to:
9.1.4.3.1 anti-glare;
9.1.4.3.2 tinting; and/or
9.1.4.3.3 polarisation.
9.1.4.4 Any enhancements will be for the member’s own account. 
 
It is therefore stated that we do not provide cover for the hardener in question and non-PPN frames.

We have also queried with our administrators whether the chosen frame is a PPN frame, if this is the case the Optometrist should not have charged for the shortfall, however as previously advised the Optometrist has confirmed the shortpayment of R74 has now been waivered. 

We will provide further information in due course.

Regards
Siddeeq on behalf of GetSavvi Health 
CB
Chrisna B's update28 Feb 2023, 13:01
Reviewer Update
Siddeeq,

I realize some people are just incapable of understanding. Let me try again to tell you what my issue is :

My husband went to Pretoria north Spec savers ( One of your network optometrists ) for the following :

1 x Standard eye test
1 x PPN Frame &
1 x set of STANDARD single vision lenses.

This is what we asked for.... that's it ..... NO EXTRAS, NO ENHANCEMENTS EXT....

Spec savers told me there is a excess on the frame and I need to pay for the hardener that is USED TO PRODUCE THE LENSES. I told them I want what GetSavvi covers ONLY... NO EXTRAS ....
They told me THE LENSES CAN NOT BE MADE WITHOUT THE HARDENER....

Now... I am no expert in lens making.... as I told you numerous times.

My issue is whether the hardener is necessary or not is not my problem - my problem is that there is an expectation for me to pay money for something that I paid you to cover.

Whether the problem lies with you not keeping to our contract or whether the problem is with Spec Savers trying to make me pay for something I do not need and did not ask for I do not know yet... I am waiting for the lab report stating which is true.

I also think it is very unprofessional of you - my former medical insurance to have me go to one of your appointed optometrists and then when a issue like this one raises you try to make me out as the idiot in stead of trying to get to the bottom of the issue at hand.



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Getsavvi Health
Getsavvi Health's reply28 Feb 2023, 16:41
Official
 Good day Chrisna  

We would like to sincerely apologise for the experience you’ve had with GetSavvi Health.  

Due to the confidentiality of the information provided, we have responded to you privately via , telephone and we will keep you updated.

Thank you for your understanding during this resolution process. 

Should you have any further concerns, please contact us via email or telephone.



 Regards
Lesley on behalf of GetSavvi Health  
CB
Chrisna B's update28 Feb 2023, 17:26
Reviewer Update
Thank you Lesley,

I will also keep you updated with the lab report. Looking forward to resolving this issue.

Regards,
Chrisna