1 reviews | Active since Feb 2011
Feedback from Scheme and consultant on behalf of Scheme
Dr. DF Van Der Merwe practice number ********** conducted a Shortening Osteotomy right 3rd Metatarsal Procedure during February 2018. The Specialist provided quotation, Medical Scheme allowed pre op authorization. After surgery scheme opt to allow only a +- 30% payment with the following reasons; the Practitioner overcharged in relation to scheme fees and that authorization do not guarantee payments only a go ahead for the surgery. I as the responsible person for outstanding account not compensated by scheme accept that the Medical Aid cover cost to scheme fees and that authorization do not reflect full payment. My barriers is that when info related to, confirmation of medical rates and the difference between the practitioner invoice paid and scheme rates paid on claim status differ, no progress was obtained from entity and the info provided by consultant and scheme do not add up to invoices, accounts and claim acknowledgements.
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
With reference to your Hello Peter Complaint received on the 08/05/2018.
Kindly provide us with your membership number in order for us to prioritise the investigation and provide you with a prompt response.
Should you require any further assistance please contact the Medshield Medical Scheme contact centre on ***
Yours sincerely,
Medshield
Good day
With reference to your Hello Peter Complaint received on the 08/05/2018.
Kindly provide us with your membership number in order for us to prioritise the investigation and provide you with a prompt response.
Should you require any further assistance please contact the Medshield Medical Scheme contact centre on ***
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 upon the investigation completed.
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 upon the investigation completed.
Yours sincerely,
Medshield
Good day
With reference to your Hello Peter Complaint received on the 08/05/2018.
Upon the investigation we can advise as follow:
We have received the account from doctor Van Der Merwe ,practice number *** ,treatment date 06/02/2018 , dependent William Correll ,amount charged 7,825.14 . The above account has been reviewed ,reversed & reprocessed to be paid correctly at scheme rate and amount to be paid on the next payment run is R 2,981.89 . The above doctor charges the private rate hence the account short paid .
Yours sincerely,
Medshield
Good day
With reference to your Hello Peter Complaint received on the 08/05/2018.
Upon the investigation we can advise as follow:
We have received the account from doctor Van Der Merwe ,practice number *** ,treatment date 06/02/2018 , dependent William Correll ,amount charged 7,825.14 . The above account has been reviewed ,reversed & reprocessed to be paid correctly at scheme rate and amount to be paid on the next payment run is R 2,981.89 . The above doctor charges the private rate hence the account short paid .
Yours sincerely,
Medshield