Are you kidding me?!?

<p>June 2015 Genesis Hospital claimed their authorised in hospital fees from Medihelp for my sons birthing, 6 months later and after I had to intervene, running hours of calls between the hospital & Medihelp, received hundreds of calls from the debt collectors, arranged for debt repayment and started with payments, only then did Medihelp sort out the outstanding account from Genesis in November 2015 and paid in full. Medihelp kept alleging that Genesis needed to come to the party with an amended revised account. FOR 6 MONTHS!</p> <p> </p> <p>2nd scenario- Baby went to Kloof hospital in February 2016, blood was taken and claimed from Medihelp for in-hospital fees, which should be covered. Medihelp apparently rejected the claim stating they require a revised account from Lancet. After 3 months and after receipt of an sms threatening legal action from lancet for R 3400, I called Lancet & Medihelp only to find out that no one from Medihlep bothered to follow up their claim rejection and requesting of new information, and that medihelp in fact pulled through wrong codes, which was only rectified yesterday after I had to intervene AGAIN.</p> <p> </p> <p>I asked to speak to the manager to see if we can get a solution to this recurring problem of me receiving threats months later because of Medihelps incompetence. Only to be told by this Manager Adri who seems hell bound on passing the buck to the client, that the moment they reject a claim it becomes the clients responsibilty as Medihelp does not have THE CAPACITY to follow up on their rejections requiring responses from claimants. (Now im not talking about rejections based on incomplete funds- those I get, these are rejections requiring medical codes etc)</p> <p> </p> <p>Now tell me how am I suppose to know as the customer what the reason for rejection is if its technical like the ones above requiring feedback from the claimants with amedned codes, who is the contact person and contact number for the claimant and any responses possibly sent from the claimant to medihelp in the meantime.</p> <p>We pay a monthly fee to cover the medical aid inclusive of adequeat capacity to deal with these simple situations. Medihelp has time to reject claims and send out reports to the claimants stating the information required but no time to simply follow it up before their paying loyal customer receives lawyer and debt collector threats. I should not be placed at risk of being blacklisted because Medihelp refuses to their jobs.</p> <p> </p> <p>Maybe the monies they "take" from decreaing the savings should be utilised for adequeat employee capacity to enable them to NOT BE ***********, properly deal with situations they cause and provide proper feedback and good service to their clients.</p> <p> </p> <p>I am very angred with Medihelps attitude and even more so with the Manager whom represented Medihelp yesterday.</p> <p> </p> <p>THis is UNACCEPTABLE! Medihelp own up to your mistakes and Inadequacies, take responsibility and do your jobs, and stop putting your customers at risk.</p>