EZ
Elzaan Z
1 reviews | Active since Jul 2014
15 Mar 2016, 08:12
Website
Hi, I submitted a claim to Medihelp on your website on the 3rd of March 2016. I called the call center to inquire on the claim and was advise I need to call back on Monday as the claim is in progress. I called back and then I was informed that I need to please email the documentation to them as the claim was not received. This is unacceptable. I am sooo angry with regards to this as I needed the money to be paid back. I never had this problem with my previous medical aid. You are quick in a month to take your membership fee but then nothing works on your side. My husband received an email confirming that the claim has been received and will be processed with in 10 days. Is this 10 working days or 10 consecutive days. Specifications on a website or email is key in anything these days. I am not happy with the fact that I will need to wait another 10 days to have this sorted out as I received confirmation on my first submission of a claim. SORT THIS OUT ASAP.
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Medihelp's replyOfficial
15 Mar 2016, 11:09Hello ElzaanZ,
All claims received in the Scheme are subject to an assessment process whereby the claim is allocated into an electronic bundling system, prior to processing. However, during the bundling process, which might take a day or two, detail of the claim will not yet be visible on our electronic system and a Contact Centre consultant will not be able to determine whether the claim was received in the Scheme. Once a claim number is allocated to a specific claim, an SMS is sent to the member confirming receipt thereof. The claim is then assessed according to the Medihelp Rules and the member's benefit option.
Medihelp is governed by the Medical Schemes Act, 1998 which stipulates that claims must be processed within 30 days after receipt of a valid claim.
Medihelp's client service philosophy relies on fast and efficient claim processing and claims are usually processed within 10 days after receipt thereof. However, due to present high volume claims received, we are unable to processes your claim sooner.
Your complaint has been referred for investigation and a consultant will contact you in this regard.
Kind regards
Medihelp Customer Care
All claims received in the Scheme are subject to an assessment process whereby the claim is allocated into an electronic bundling system, prior to processing. However, during the bundling process, which might take a day or two, detail of the claim will not yet be visible on our electronic system and a Contact Centre consultant will not be able to determine whether the claim was received in the Scheme. Once a claim number is allocated to a specific claim, an SMS is sent to the member confirming receipt thereof. The claim is then assessed according to the Medihelp Rules and the member's benefit option.
Medihelp is governed by the Medical Schemes Act, 1998 which stipulates that claims must be processed within 30 days after receipt of a valid claim.
Medihelp's client service philosophy relies on fast and efficient claim processing and claims are usually processed within 10 days after receipt thereof. However, due to present high volume claims received, we are unable to processes your claim sooner.
Your complaint has been referred for investigation and a consultant will contact you in this regard.
Kind regards
Medihelp Customer Care
Best regards,
Medihelp's reply15 Mar 2016, 11:09
Official
Hello ElzaanZ,
All claims received in the Scheme are subject to an assessment process whereby the claim is allocated into an electronic bundling system, prior to processing. However, during the bundling process, which might take a day or two, detail of the claim will not yet be visible on our electronic system and a Contact Centre consultant will not be able to determine whether the claim was received in the Scheme. Once a claim number is allocated to a specific claim, an SMS is sent to the member confirming receipt thereof. The claim is then assessed according to the Medihelp Rules and the member's benefit option.
Medihelp is governed by the Medical Schemes Act, 1998 which stipulates that claims must be processed within 30 days after receipt of a valid claim.
Medihelp's client service philosophy relies on fast and efficient claim processing and claims are usually processed within 10 days after receipt thereof. However, due to present high volume claims received, we are unable to processes your claim sooner.
Your complaint has been referred for investigation and a consultant will contact you in this regard.
Kind regards
Medihelp Customer Care
All claims received in the Scheme are subject to an assessment process whereby the claim is allocated into an electronic bundling system, prior to processing. However, during the bundling process, which might take a day or two, detail of the claim will not yet be visible on our electronic system and a Contact Centre consultant will not be able to determine whether the claim was received in the Scheme. Once a claim number is allocated to a specific claim, an SMS is sent to the member confirming receipt thereof. The claim is then assessed according to the Medihelp Rules and the member's benefit option.
Medihelp is governed by the Medical Schemes Act, 1998 which stipulates that claims must be processed within 30 days after receipt of a valid claim.
Medihelp's client service philosophy relies on fast and efficient claim processing and claims are usually processed within 10 days after receipt thereof. However, due to present high volume claims received, we are unable to processes your claim sooner.
Your complaint has been referred for investigation and a consultant will contact you in this regard.
Kind regards
Medihelp Customer Care
Best regards,