lG
lilanie G

1 reviews | Active since Oct 2020

28 Oct 2020, 11:47

Medshield shocking service

I am very upset and unhappy with Medshield. We have been members for more than 20 years and have always received good service. However, the past year the COMMUNICATION has been shocking.

A year ago my own health took a really bad turn and I had several procedures done after suffering a TIA. I had endless troubles as the fund "approved" an operation with a co-payment of r 10000 and in the end I had to pay an additional R 40 000.

This year my son had a bad accident with his bicycle and i had a small procedure sone, both of which i had to make co payments to the hospital. Last month my daughter needed surgery to remove 8 teeth in order for her to have ortho work done. i was given a letter of authorisation, just to get hear afterwards that a total of 14 000 was not paid due to member benefits run out. I do not work for the medical aid - i am a single mom with three teenagers. are they not supposed to at least say - authosied but due to benefits that ran out you will need to pay in x amount? Is that not the decent thing to do? i have to loan from my kids savings to PAY MEDICAL BILLS, yet i pay R 6000 per month? for 12 years we barely touched the fund!

also - i sent various mails asking for assistance or feedback - to NO AVAIL - not even an email reply. Also medshield suddenly recently said they could not mail me as my mail address on the system was my deceased husband's (3 years now!).

i am really disgusted with the service received. Shocking communication. I hope this attracts some attention at least.

Also see part of one of my last emails to Medshield. still no reply two weeks later!! sent the below messages - asking for authorisation on a procedure. If I read this correctly it sound like it was covered - apart from the hospital surcharge that I agreed to.

- I sent communications re change of email address - it was not done - later when I phoned I was told they could not make the change as my (deceased) husband was the main member and I cannot change it - I phoned medshield who referred me to denis. - denis sent me the attached letter. I spoke to them on the phone as well. They simply said it was approved.

According to the letter I had to pay in R 3400. I was willing / able to pay this, but now you only paid R 5000 of R 13500? This was not communicated clearly! I could have had the operation done next year!

Please reply urgently.

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Replies (2)
Medshield
Medshield's reply28 Oct 2020, 12:04
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

Best regards,

Medshield
Medshield's reply04 Nov 2020, 11:16
Official
Good day 
 
 With reference to your enquiry
 
 Kindly note, the account for Dr Sarel Botha ***, dated 05/10/2020 has been processed correctly please refer to a detailed email send to your registered email address with the Scheme. We trust you find the above in order  Yours sincerely  Medshield

Best regards,