PZ
Pam Z

1 reviews | Active since Nov 2012

22 Aug 2016, 18:41

Specialized radiology almost unpaid

<p>On 09.08.2016 my daughter was admitted at Parklane Clinic, after an acute abdomen and pelvic pain and on 11.08.2016 a CT Abdo and Pelvis was done which confirmed extensive faecal loading, mesentric/abdominal lymphadenopathy, renal cyst and Medihelp approved the auth as ********** 100077, however to my shock, Medihelpis processing the claim at R1998.00 and I am liable for R6108.00, literally meaning Medihelp is NOT funding this specialised radiology service which I have more than R17000.00 Specialised Radiology Benefits p/a. In the meantime I will escalate this matter to CMS and the Media as Medihelp does not want to fund where they should. I will as well go to CMS and the Media for old claims as follows that I paid cash or from PMSA:</p> <p>1. Dep-02,28 Feb Mulbarton admission foe dep-01 whereby I paid the diferrence to Dr Rolland (paid from PMSA), Pathology for a PMB admission</p> <p>2. Dep-01, 2009 Clinix admission for PMB condition (post op Septicaemia) which is a DTP PMB condition</p> <p>3. Dep 01-All 2 ********** Radiology and Pathology claims for PMB admission at Brenthurst on Necessee Option</p> <p> </p>

0
Replies (2)
Medihelp
Medihelp's reply23 Aug 2016, 05:04
Official

Dear PHELADI.Z

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

Medihelp
Medihelp's reply25 Aug 2016, 07:59
Official

Dear PHELADI.Z

As telephonically discussed, a correction has been done on the account in dispute. Details of the processing of the account from your specialised radiology limit, will be reported on a future summarised statement.

With reference to the other account enquiries, it was confirmed that it has been dealt with and that you were satisfied with the feedback.

Kind regards

Medihelp Customer Care