Pathetic Medical aid

Good day,

Please advise what the issue with payment for the above service date for Dr Urisha Brijlal is? This Dr was the Locum by Medi-Clinic Cape Gate working in their hospital over that weekend when i was admitted through ER when i had a Blackout at home and rushed to ER to be admitted!

Medihelp is causing great frustration to their members by always looking for excuses not to pay service providers after giving authorisation for procedures! T & C’s says no service will be paid unless authorisation is obtained except for emergencies! However medihelp always find a way to reject claims even emergencies admitted to hospital.

I have full in hospital cover at medical tariff rate of 100% therefore only shortfalls should apply which will be covered by my gap cover! So where in hell do you people find the reasons to reject claims and to use codes not applicable to hospital admissions!

Statement also reflects payment made to member! I received no dime from Medihelp for this Dr! And why would you pay me for a service provider rendered in hospital! Please rectify your **** and sort out this service provider because you people are making us more sick and giving us high blood pressure while use are suppose to be a help to our cure!