cE
charmaine E

1 reviews | Active since Apr 2015

09 Mar 2016, 15:58

POOR SERVICE DELIVERY AND NO COMMITMENT

I WAS A MEMBER(***1) ON RESOLUTION HEALTH IN 2015. I WENT TO THE GYNEA FOR WHICH I GOT A AUTHORIZATION (NEO***A). I WAS THEN TAKEN UP IN HOSPITAL AGAIN PRE-AUTH ACQUIRED. THE HOSPITAL ACCOUNT WAS SETTLED HOWEVER THE ACCOUNT FOR THE DAY BEFORE WAS REJECTED. WHEN I PHONED THEY SAID THEY DID NOT HAVE THE AUTH NUMBER WHICH THE PRACTISE THEN SUPP**** THEM WITH THE SAME ACCOUNT WITH THE AUTH AGAIN, AFTER IT WAS SUBMITTED VIA HEALTHBRIDGE . RESUBMISSION 31/08/2015 VIA PAPERCLAIM CLIENT [Email Removed] SUBMITTED AGAIN IN OCTOBER AFTER YET ANOTHER A STORY. AFTERWARDS I WAS TOLD IT IS A STALE CLAIM. THEY DID RECEIVE THE CLAIM WITH IN THE 4 MONTH PERIOD BEFORE IT IS DECLARED A STALE CLAIM. SOMEONE DID NOT DO THEIR JOB AND NOW THE MEMBER IS BEING HELD LIABLE. WHEN REQUESTING TO SPEAK TO A MANAGER I WAS TOLD EVERY ONE IS IN A MEETING . I FEEL IT IS ABSOLUTELY RIDICULOUS . I WANT THIS RESOLVED ASAP.

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Replies (1)
Health Squared Medical Scheme
Health Squared Medical Scheme's reply09 Mar 2016, 18:55
Official
Hello CATICE,

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