OF TOPIC RESPONSE

<p>PLEASE FIND BELOW MY RESPONSE RECIEVED FROM MEDSHIELD </p> <p> </p> <p> </p> <p>Good day farhaan</p> <p>Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.</p> <p>This email serves to confirm that we have received your complaint and we have reviewed the feedback received. It has been noted that our authorisation department has advised the provider and yourself about an approved authorisation. It has been advised that Internal Prosthesis limit is R31, 00.00 and there will be no co-payment and Iron drip was also included as part of the authorisation. We have listened to the calls made no where it mentioned Violet`s name.</p> <p>Please be advised that our principal office is currently on leave.</p> <p>We trust that you find the above in order.</p> <p><br />Should you require any further assistance please contact the Medshield Medical Scheme Contact Centre on ********** .</p> <p><br />Yours sincerely</p> <p><br />Cleopas Tseka</p> <p> </p> <p> </p> <p>MY ENITIAL QUESTION WAS WHY DID THE AUTHORIZATION TAKE SO LONG TO BE APPROVED YET THEY HAD THE NECCESARY DOCUMENTS WHY WAS I TOLD BUY THE CONSULTANT THAT THERE WAS NOTHING LOADED ON THE SYSTEM WHEN I CALLED EARLIER THAT DAY FOR THE IRON DRIP I DID NOT REQUEST THAT A LIMIT SUMMARY BE SENT TO ME. </p> <p>FURTHET MORE WHE HAVE BEEN RECIEVING EMAIL WITH CLAIM STATUS NITIFICATIONS LIKE BELOW </p> <p> </p> <p> </p> <p><br />Treatment Date Beneficiary Code Beneficiary Claim Number Tariff Code Amount Charged Tariff Amount Paid to Provider Paid to Member Members Portions Remark Code<br />12/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />11/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />611.40 611.40 0.00 0.00 0.00 <br />.<br />Supplier: DR JB FICHARDT INCORPORATED<br />Treatment Date Beneficiary Code Beneficiary Claim Number Tariff Code Amount Charged Tariff Amount Paid to Provider Paid to Member Members Portions Remark Code<br />09/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />305.70 305.70 0.00 0.00 0.00 <br />.<br />Supplier: DR G J VISAGIE<br />Treatment Date Beneficiary Code Beneficiary Claim Number Tariff Code Amount Charged Tariff Amount Paid to Provider Paid to Member Members Portions Remark Code<br />10/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />13/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />14/03/2017 00 VERONICA REBECCA GILCHRIST EDI ********** ********** 305.70 305.70 0.00 0.00 0.00 514/752<br />917.10 917.10 0.00 0.00 0.00 <br />.<br />Explanation of Remark Codes<br />514 - Benefit limits and/or savings have been used up<br />752 - Benefits not allowed by Scheme - Therefore error 514 attached<br />.<br />Explanation of Tariff Codes<br />0109 - At hospital or nursing home: All hours</p> <p> </p> <p>WHY ARE ALL THE VISIT THAT WERE MADE BUY VARIOUS DOCTORS IN HOSPITAL REJECTED WITH THAT CODES.</p> <p> </p> <p>FURTHER IF THE PRINCIPAL OFFICE IS ON LEAVE WHO IS CURRENTLY DEALING WITH HIS RESPONSIBILITIES AND WHY WAS THERE NO ALTERNATE EXTENSION. </p> <p> </p> <p>MEDSIELD DOES NOT RESPONSE ON THE RELEVANT COMPLAIT RATHER THEY MISREAD AND GIVE A LAUSY SWEETEND EXPLAINATION JUST LIKE WHEN YOU CALL IN TO THE CALL CENTRE. </p> <p> </p>