SN
Simangele N

1 reviews | Active since Jul 2011

23 May 2017, 09:41

Claims not settled and poor service

<p>I was hospitilised from the 26/04/2017 and I was dischrged on the 06/05/2017. It was due to my mental health I had a beakdown I needed to go to a mental hebalitaion centre. in that centre the are therapies that are put in place to help you heal and be able to have a good merchanism when you get out of the intitiuton. as far as I know everything falls from my PMB benefit. i was surpised to hear that the are claims that were reject by the medical aid due insuffient savings mind you I have a hospital benefit. so whats the point of having a hospital benefit if they still going to claim from your savings. and I get a lame excuse that the claim was lodged incorrectly by the servise provider.</p> <p>The same thing happened last year when I was in the same instituition the service provider was not paid and I was not informed I had to deal with threathning Schulenburg Attorneys who registered me on ITC as an adverse.</p> <p>my pschologist lodged claims and they were rejected because I dont have saving to my surprised I have mental health treatment plan put n place and I have 15 consulataion of which i used maybe about 3 at that time.</p>

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Replies (2)
Medshield
Medshield's reply23 May 2017, 11:18
Official

Good day,

Medshield Medical Scheme has acknowledged your complaint and is currently investigating.

Kindly note that your concerns have been prioritised and feedback will be provided within 5 working days.

Yours sincerely,

Medshield

Medshield
Medshield's reply24 May 2017, 11:23
Official

Good day,

Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.

On receipt of the complaint referred to herein, the Scheme can confirm the following:

We have reviewed all claims for your admission period and a detailed breakdown has been send to your e-mail address ***

Kindly note, none of the claims for this admission has been funded from your Day-to-Day benefits.

On behalf of the Scheme, we would like to unreservedly convey our apologies to you for any frustration and inconvenience that you might have experienced as a result of the poor handling of your enquiry. We would further like to provide you with the assurance of Medshield's commitment to improved service delivery as you as the member is an important partner to our Scheme.

Should you have further enquiries kindly contact us on *** or email ***.

Yours sincerely,

Karin Binstead

Medshield Medical Scheme