1 reviews | Active since Jun 2020
Pathetic medical aid. 29 weeks pregnant and still no response with regards to my pre-auth for birth
I joined medshield in November 2019. On the 6th of January 2020 we found out we are pregnant. I was sent for a scan by my GP as he thought the pregnancy was ectopic. On the 7th it was confirmed that it is a normal pregnancy everything is fine.
I then made contact with the medical aid to inform them of the pregnancy and confirm if I am covered.
No response from the medical aid after I called I was told the turn around time to reply is 10 working days. I then went ahead a emailed the complaints team. I was contacted by a consultant Toneal Williams in January. I explained the situation but mentioned that I have moved from fedhealth to medshield will my pregnancy be covered. She reassured me that the pregnancy will be covered. Fast forward to April. I require hospital authorization for the birth. I again email the medical aid they provide me with the information I need to get from my gynecologist. Please note I email the complaints team. Not once was it mentioned that I only joined the medical aid in November they would need to investigate if the pregnancy would be covered. My understanding is they should have looked into this then already.
I receive all the codes etc from my gynecologist and I send it off the pre auth team.
I receive a phone in the first week in June explaining they now need to investigate this as I only joined the medical aid in November and require information from my GP. . I am 27 weeks pregnant at the time. I explain to the consultant that this was confirmed to me by Toneal Williams in January... The consultant Siongile Saps says that if the pregnancy was only confirmed in January there should be no issues. I say her forward me the form I will get my GP to complete it.
On the 2nd of June I return the completed form to medshield and the turn around time is 72 hours.
Yesterday the 09/06/2020 I call to follow up as I see the claim is denied on my app. The consultant says they are waiting on the document from my GP. I say I sent this in on 2nd June 2020.
I am now 29 weeks pregnant with no Idea as to where I will give birth.
I keep getting auto mated response no one picks up the phone to inform you of anything.
Pathetic service
Medshield
Medshield
