WJ
Woutrien J

1 reviews | Active since Feb 2017

05 Jul 2021, 18:27

Unpaid medical bill

I have been a member of this medical aid since 2001. I am the main member and my premiums are paid every month without hassles. In June 2020 my husband was diagnosed with bone marrow cancer. The oncologist submitted the forms to have him registered on the oncology register as he needs to be registered on the bone marrow transfer register. A procedure that was supposed to take two weeks, took ten months to sort out . I had to make constant phone calls and send various emails to get a resolution. After eventually receiving the authorisation with the relevant codes to be used, the first account submitted with these particular codes was rejected with the reason : codes not authorised. Once again it was my job to get the authorisation report from the doctor and resubmit the clain with the authorization report attached. Upon receipt of the claim I received an email on 22 June 2021 stating that the claim has been received and is being processed. To date no payment has been made to the doctor and as the treatment date was the 13 Apri 2021 the doctor now refuses to treat my husband before this account has been paid and I was given 3 days to pay the account or be listed on all Crdfit Bureaus. My husband has an appointment with the doctor tomorrow 06 July 2021 and I am now forced to pay the consultation in cash to receive treatment ,that is supposed to be paid by my medical aid. This is not acceptable as I pay a medical aid subsription monthly,which should handle these type of cases.

0
Replies (1)
Hosmed Medical Scheme
Hosmed Medical Scheme 's reply20 Jul 2021, 17:13
Official
Dear Mrs. Jooste,

Thank you for your valuable comment.

Our CRM team will contact you shortly to obtain the necessary information to investigate the matter.

Kind regards
 Hosmed - Care for Life