JG
Justin G
1 reviews | Active since Nov 2009
15 Dec 2015, 15:47
Cannot get an Autorisation approved
I recently had an op in order to clean the wound as it had gone septic. I was discharged and was been treated by a wound care practitioner. Every-time I have queried what the delay in getting the authorisation approved they come with another excuse informing me that another piece of paperwork was missing. I have actually stopped with any form of wound treatment as I am getting very scared that the claim will be rejected. On Friday 11/12/2015 I called again to find out what is happening and that insisted that they were just waiting for a LOM for treatment for December 2015. I informed the call centre agent that my last treatment was 02/12/2015 she informed that it would be forwarded to the case manager for settlement. Today I called and was given a list of things missing.I am tired of all this run around please can somebody who can make a binding decision contact me regarding this matter. Will this matter just be dragged on and possibly end up in hospital again.
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Replies (2)
Medihelp's replyOfficial
17 Dec 2015, 07:44Hello justing69,
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Best regards,
Medihelp's reply17 Dec 2015, 07:44
Official
Hello justing69,
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Best regards,
JG
Justin G's updateReviewer Update
20 May 2017, 22:21The end result was that I ended up in hospital twice after this. The wound care practioner kept assuring me that she was getting authorisation and she did not follow medical aid guide lines by submitting a report after each treatment so the funds were just taken out of my savings. I was so exhausted after all this run around, I just left it at that. Some care providers do not follow the medical aid requests and the member ends up paying.
JG
Justin G's update20 May 2017, 22:21
Reviewer Update
The end result was that I ended up in hospital twice after this. The wound care practioner kept assuring me that she was getting authorisation and she did not follow medical aid guide lines by submitting a report after each treatment so the funds were just taken out of my savings. I was so exhausted after all this run around, I just left it at that. Some care providers do not follow the medical aid requests and the member ends up paying.