I joined this medical aid to rid of the bureaucracy that Discovery medical aid had, in terms of over-selling and not complying with individual patients/members needs and I am paying more on this medical scheme than I did with Discovery.
Only to find that this medical aid is extremely inefficient when it comes to reimbursing their patients/member claims. No one takes the time nor the effort to explain to a new member how or what the process is ito claiming, and when you do, you receive an automated email from them as quoted below.
Medihelp Email: "The amount will be available in your bank account after 5 to 7 working days. Medihelp has three payment runs, namely the 10th, the 20th and the 30th of every month."
The point I am trying to make here is that I visited the doctor on 08/06/2019 and claimed a mere R675.00 from you (Medihelp). The claim was emailed to you on the same date at 12:32pm. As is always the case with medical aids they only reimburse you a proportion of the amount of R401.40.
You claim in the email sent (as quoted above) that you only have certain days on which you effect payment which is totally understandable. What I do not understand is that to date you still have not processed the claim.
You claim that it takes 5 days to process a claim. If that is the case then why was I not reimbursed and paid out on the 20th as that would have given you ample time to process the claim and reimburse the member.
Please could you be consistent in your claim process as this is not what I am used to after being a member of Discovery for over 16 years. They may have all the bells and whistles BUT at least they were effective and efficient when claims were submitted to them.
*Please don't send me a response saying that the money will be transferred into my account on 24/06/2019 as I know that.
I need to know why it was not processed on the date as per your quoted email, and why you now all of a sudden effect payments on the 24th as those are not the dates stipulated in your response to me.
Be consistent and be efficient when you process claims!
Best regards,
Best regards,
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