EC
Elna C

1 reviews | Active since Jul 2013

17 May 2015, 21:17

Medical aid did not pay one cent!

I saw my dentist on 11/03/2015 with a painful tooth. The pen that holds the crown broke and got stuck in my jaw. Afterwards I developed an abscess and had to use different antibiotics. At last I had to see a surgeon and he recommended surgery to get the pen out of my jaw. There was no other way , because the abscess was so severe they could not do this in his rooms. I phoned Medihelp and send the motivation letter from the surgeon and the x-rays to them via e-mail. They refused to give me an auth. number for the procedure . According to them the rules stated that this has to be done in the rooms of the dentist except when you are mentally sick!!. I tried to explain that this was not a normal extraction of teeth, but they won't even let me speak to a case manager!. The only way to get rid of the abscess was to pay for the whole operation myself. I paid the day clinic, the anaesthetist and the surgeon to get the pen out of my jaw (on 27/03/2015) and extracted my teeth, R30 000. Medihelp did not pay one cent. Afterwards I wrote them a letter explaining the whole situation and send them all the bills, but still they did not pay anything. Why do I have a medical aid?

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Replies (1)
Medihelp
Medihelp's reply18 May 2015, 08:13
Official
Hello elnacon,

Your complaint was referred to our client services department for investigation and a consultant will contact you in this regard.

Kind regards

Medihelp Customer Care