AP
Andre P

1 reviews | Active since Mar 2009

27 Nov 2015, 11:15

Bad Service - Claims and Pre-authorisation

o Claims:<br> o I sent an e-mail to client services (refer attached) on 18 Nov. I did not receive a reply that this mail / claim was received or no form of acknowledgement / reference number <br> o I then followed up whether the claim was received via telephonic call on 25 Nov. The call centre agent told me that the claim was not logged and that he would log the claim. I did not get any form of reference number for the call or claim<br> o I then called again on 26 Nov to follow up on the claim and spoke to client services who told me no claim was logged? I again gave the details and this time I got acknowledgement that the claim was logged<br> o There was no communication throughout the entire process and I had to call Resolution to get the matter resolved and believe you have some gaps in your client service process<br> o Pre-authorization:<br> o Called for authorization on Wednesday, 25 Nov and was told I would be called with a pre-auth reference number. I did not receive a call or reference number <br> o I followed up again today and was told the authorisation has not been done? I had to go through the process again to get a number<br> o I was told a client services manage would call me back, but I'm

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Replies (1)
Health Squared Medical Scheme
Health Squared Medical Scheme's reply27 Nov 2015, 14:12
Official
Hello anpeters,

We acknowledge receipt of your concerns and thank you for bringing them to our attention. Resolution Health is committed to providing an unsurpassed level of service excellence to our valued members and would like to extend our sincere apologies if you feel that we have fallen short of this promise. We are assigning a dedicated consultant to your query and he/she will be in touch soonest to discuss your concern in further detail.

Please rest assured that your query will be dealt with as a matter of urgency and that we are fully committed to resolving this as soon as possible.

Yours in health and wellness,

The Resolution Health team.