TM
Takalani M

1 reviews | Active since Sept 2017

03 Jun 2019, 15:40

Pathology test not paid what is the reason

I am not happy with the payment department pathology test claims we done and claim sent same week but no payment done the status still saying processing y other claims doesn't take time to be paid other are left unattended. I have been using this medical aid for over 2 years but wat I'm getting now doesn't make me happy

0
Replies (2)
Medshield
Medshield's reply04 Jun 2019, 06:44
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
Medshield
Medshield's reply12 Jun 2019, 15:00
Official
Good day,
 
As discussed telephonically ,please be advised that account from Akasia Hospital Pharmacy for Ompha Ronel and Akonaho Petunia, treatment date 29-30/05/2019 has been rejected correctly as medication need to be dispensed from Mediphila pharmacy network. Furthermore, with regard the account from doctor Mametja, practice number *** treatment date 03/06/2019 and dependent Takalani Sarrinah, please note that account has been released for payment to pay the service provider . Lastly , please note that account from Mauff A C & Partners, practice, number *** , treatment date 16/05/2019, dependent Takalani Sarrinah and amount charged R1,522.10 , the provider has submitted the account incorrectly as in hospital patient hence the account is on hold with the following remark ( Associated Provider claim on hold - Awaiting possible par update.) . It should be noted that we have contacted the provider on the 04/06/2019 to advise and they said they will send amended account with correct details, however, we haven’t receive account till to date.
Yours sincerely,Medshield