AA
Aziz A
1 reviews | Active since May 2012
15 Mar 2018, 11:13
Please help me
I recently joined Medshield medical aid and i am on the Medphila option. My cover was to effectively start on the 01-03-2018. During the month of February 2018 i got very ill and as i was joining Medshield, i went to one of the approved Dr's on their option (Dr K Omar, Practise # ********** ) She sent me for blood tests and i was diagnosed with Diabetes. My query comes in with regards to the below; I sent numerous emails to Medshield asking if this will be covered and i was told that my Dr (whom Medshield referred me to) needs to call Chronic Management to motivate this, she does not want to call them and she just says she will email them. On Monday i sent a copy of the script to ********** and i have not heard from Medshield since. Today i call and find out that there is no record of my email and the lady who assisted did it telephonically. She further tells me that the blood test results which were required were not sent by the Doctor. Please bear in mind that this Dr is a Dr that Medshielf referred me to and she really has not lived up to the standard that Medshield is striving for. Can i change my Gp? as i want nothing to do with her, she is not patient centric, she also did not even prescribe a glucose monitoring device, does the medical aid cover that? Further to my approval for Chronic Medication, i was prescribed Staminogro which is a B Vitamin supplement, this is as diabetes medication does deplete the B vitamins in the body, but it is been rejected Can someone please help
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Replies (8)0
Replies (8)
Medshield's replyOfficial
15 Mar 2018, 11:19Good 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's reply15 Mar 2018, 11:19
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's replyOfficial
19 Mar 2018, 10:42Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Kindly provide us with your membership number in order for us to prioritise the investigation and provide you with a prompt response.
We have been trying contacting you on the number registered on hello peter however it’s on voice mail.
Should you require any further assistance please contact the Medshield Medical Scheme contact centre on ***.
Yours sincerely
Medshield
Best regards,
Medshield's reply19 Mar 2018, 10:42
Official
Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Kindly provide us with your membership number in order for us to prioritise the investigation and provide you with a prompt response.
We have been trying contacting you on the number registered on hello peter however it’s on voice mail.
Should you require any further assistance please contact the Medshield Medical Scheme contact centre on ***.
Yours sincerely
Medshield
Best regards,
AA
Aziz A's updateReviewer Update
19 Mar 2018, 11:27Hi
my number is ********** ********** 140
AA
Aziz A's update19 Mar 2018, 11:27
Reviewer Update
Hi
my number is ********** ********** 140
AA
Aziz A's updateReviewer Update
19 Mar 2018, 13:35Hello. Pls can you call me urgently. I received approval that my chronic medication has been approved now I go to the pharmacy and I'm told nothing has been approved and I need to make co payments in all the meds.
Can someone pls helo
AA
Aziz A's update19 Mar 2018, 13:35
Reviewer Update
Hello. Pls can you call me urgently. I received approval that my chronic medication has been approved now I go to the pharmacy and I'm told nothing has been approved and I need to make co payments in all the meds.
Can someone pls helo
Medshield's replyOfficial
19 Mar 2018, 14:46Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Upon the investigation kindly be advised as follow.
We have received an account for Dr Omar M for an amount of R 354.44 and amount paid R 282.00,account has been paid at scheme rate, tariff code 4050(Glucose strip-test) for an amount of R 17.90was rejected for Service not part of Fixed fee agreement.
The scheme haven’t received any pathology account from the provider however once account received it will be processed according to scheme rule and benefits available.
Dependent 00 is registered for chronic medication for the following condition Diabetes Mellitus 2 , Depression and Hyperlipidaemia as from the 13/03/2018. With regarding changing a GP, you are allowed change however you can only choose from the once that are registered on the scheme website.
The Glucometer is covered by the scheme, you need to send quotation and motivation letter from the valid practise to *** . We have confirmed with Chronic Medicine management and they advised that Staminogro vitamin may not be covered under member chronic medication as it’s a vitamins and not PMB , You plan only cover PMB medication. Please note that chronic medication must be obtained from DSP( Clicks direct medicine )to avoid co-payment ,their contact number are as follow *** .
We trust you find the above in order.
Yours sincerely
Medshield
Best regards,
Medshield's reply19 Mar 2018, 14:46
Official
Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Upon the investigation kindly be advised as follow.
We have received an account for Dr Omar M for an amount of R 354.44 and amount paid R 282.00,account has been paid at scheme rate, tariff code 4050(Glucose strip-test) for an amount of R 17.90was rejected for Service not part of Fixed fee agreement.
The scheme haven’t received any pathology account from the provider however once account received it will be processed according to scheme rule and benefits available.
Dependent 00 is registered for chronic medication for the following condition Diabetes Mellitus 2 , Depression and Hyperlipidaemia as from the 13/03/2018. With regarding changing a GP, you are allowed change however you can only choose from the once that are registered on the scheme website.
The Glucometer is covered by the scheme, you need to send quotation and motivation letter from the valid practise to *** . We have confirmed with Chronic Medicine management and they advised that Staminogro vitamin may not be covered under member chronic medication as it’s a vitamins and not PMB , You plan only cover PMB medication. Please note that chronic medication must be obtained from DSP( Clicks direct medicine )to avoid co-payment ,their contact number are as follow *** .
We trust you find the above in order.
Yours sincerely
Medshield
Best regards,
AA
Aziz A's updateReviewer Update
20 Mar 2018, 08:07Hi Mam
Sorry to bother you. Please can you call me, yesterday we spoke and when i was at Clicks i asked hte lady to reverse everything., now Clicks have claimed R235 from the medical aid. Please dont pay this
AA
Aziz A's update20 Mar 2018, 08:07
Reviewer Update
Hi Mam
Sorry to bother you. Please can you call me, yesterday we spoke and when i was at Clicks i asked hte lady to reverse everything., now Clicks have claimed R235 from the medical aid. Please dont pay this
AA
Aziz A's updateReviewer Update
22 Mar 2018, 16:10Hi Victoria
Please help.
I been calling Direct Medicines and Medshield all day as they say my meds are not approved and I need to pay.
I even spoke to a Lee from your office and the call cut and she never even called me back.
My blood sugar is on 13 as I have not had any medication since Wednesday. What do i do now.
My biggest mistake was joining this Medical Aid
AA
Aziz A's update22 Mar 2018, 16:10
Reviewer Update
Hi Victoria
Please help.
I been calling Direct Medicines and Medshield all day as they say my meds are not approved and I need to pay.
I even spoke to a Lee from your office and the call cut and she never even called me back.
My blood sugar is on 13 as I have not had any medication since Wednesday. What do i do now.
My biggest mistake was joining this Medical Aid
Medshield's replyOfficial
23 Mar 2018, 09:39Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Kindly be advised we have liaised with Clicks direct medicine and the advised that your medication will be delivered to you by today with a co-payment of R 69.74
We trust you find the above in order.
Yours sincerely
Medshield
Best regards,
Medshield's reply23 Mar 2018, 09:39
Official
Good day
With reference to your Hello Peter Complaint received on the 15/03/2018.
Kindly be advised we have liaised with Clicks direct medicine and the advised that your medication will be delivered to you by today with a co-payment of R 69.74
We trust you find the above in order.
Yours sincerely
Medshield
Best regards,