1 reviews | Active since Apr 2014
Denied authorization
Late August 2017 my daughter went to ER and was admitted in hospital and medical aid refused to provide and authorisation and provided no reason. Now I'm left with a lot of bill to pay for no reason and my child couldn't breath. Chronic Hospital Hospital Auths Please select an auth number to view details. Auth No Beneficiary Status Authorised ********** 34 02-RETHABILE GABRIELLA MAHLOHONOLO RANTILI DENIED 29/08/2017
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
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
Good day,
Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.
Kindly note, for any members that have joined the Scheme within the last 12 months, a non-disclosure process is followed. This is a standard process for all authorisation requests for members that are on the Scheme for less than a year. An investigation into a non-disclosure does not imply that your authorisation will be declined.
We can confirm that on request for the hospital authorisation the request was pending due to the non-disclosure investigation. Information was requested from the treating provider however not received.
The Scheme has now contacted and spoken to the treating provider again and the authorisation has been approved.
Kindly note the Scheme’s hospital benefits management program, Medical Services Organisation, MSO has been trying to contact yourself telephonically to discuss the complaint in detail however with no avail.
All claims will be send to be reprocessed and will be funded to the providers in accordance to Scheme rules and protocols.
We trust you find the above in order.
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.
Kind regards,
Karin Binstead
Medshield Medical Scheme
Good day,
Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.
Kindly note, for any members that have joined the Scheme within the last 12 months, a non-disclosure process is followed. This is a standard process for all authorisation requests for members that are on the Scheme for less than a year. An investigation into a non-disclosure does not imply that your authorisation will be declined.
We can confirm that on request for the hospital authorisation the request was pending due to the non-disclosure investigation. Information was requested from the treating provider however not received.
The Scheme has now contacted and spoken to the treating provider again and the authorisation has been approved.
Kindly note the Scheme’s hospital benefits management program, Medical Services Organisation, MSO has been trying to contact yourself telephonically to discuss the complaint in detail however with no avail.
All claims will be send to be reprocessed and will be funded to the providers in accordance to Scheme rules and protocols.
We trust you find the above in order.
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.
Kind regards,
Karin Binstead
Medshield Medical Scheme