1 reviews | Active since May 2015

02 Jan 2018, 10:33

Call Centre Agents ***********

On 27 December 2017 I took my baby to Clicks Clinic to get his 6 weeks vaccinations, the pharmacist tried to claim the vaccinations but the Horizon Medical Aid kept declining the claim. I then phoned Medscheme and spoke to one of the call centre agents on 27 December 2017 he confirmed that Horizon does cover babies vaccinations and he gave me all the names of the vaccinations they cover. I went back to the pharmacist and asked her to try and put the claim trough again, but again Horizon declined the claim, I then had to pay it myself. I phoned Horizon/Medscheme today to find out why my medical aid kept declining the claim, the call centre lady said she will find out and the she just transferred me to CareCross without telling me. I phoned back and spoke to the same lady and asked her why she put me trough to CareCross and she rep**** I have to speak to them, but I already previously spoke to CareCross and I know for a fact they don't work with the vaccinations and Horizon does. She clearly did not know how to assist me and clearly does not know how to do her job! I want someone who knows what they are doing to phone me ASAP to resolve this claim as I had to pay R1600 out of my pocket which should have been paid by my medical aid. The call centre agents name was (Francina), she is not trained properly.

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Replies (1)
Medscheme
Medscheme's reply08 Jan 2018, 10:36
Official

Good day Eric

Thank you for submitting a comment to us through Hello Peter.

This is to confirm that we have received your comment and that we are currently investigating this matter.

Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.

Kind regards
Medscheme Team

Best regards,