HVDM
HENRY VAN DER MERWE

1 reviews | Active since Mar 2012

09 May 2018, 15:18

POOR SERVICE

I have lodged on 4 January 2018 my first complaint regarding the unpaid claim for Ampath, service date 21 December 2017 and up untill today Medshield did not pay this account, to put it clearly they pay R51,1 on tariff code 4032 but reverse it a couple of days later and so they have done this but not once but four times. Every person to whom you speak keeps on saying they will investigate, you get e mails stating that it is being reprosessed. Then later on you get another e mail just to state that either the ICD10 code is wrong, limit reached/savings exhausted, duplicate claim, tariff code not listed on PMB CAREPLAN. According to all the people i spoke to since 4 January only tariff code 4032 is listed on the PMB CAREPLAN, maybe my glasses are dirty because when i look at the CAREPLAN i see the following tariff codes are listed there to 4155, 4017, 4109, 4512. Please stop running around with your feeble excuses and pay this account, i am getting tired of calling Medshield as it is costing me money.

0
Replies (4)
Medshield
Medshield's reply09 May 2018, 16:00
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 reply16 May 2018, 14:09
Official

Good day,

Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.

Your complaint has been investigated by the Scheme’s Manager Health Care Provider, MHRS and a detailed email has been send to your registered email address with the Scheme.

On behalf of the Scheme, we would like to unreservedly convey our apologies to you for the frustration during resolving your query.

Yours sincerely,

Karin Binstead

Medshield Medical Scheme

Best regards,

HVDM
HENRY VAN DER MERWE's update17 May 2018, 13:42
Reviewer Update
I have rep**** to Karin Binstead s e mail. I do not agree with her findings bacause she mentioned that only R51.10 was paid on 13/03/18 but forgot to mention aswell that this payment was reversed again on 28/03/18, so Medshield made no payment of any sort towards the Ampath account. The tariff codes she listed is part of the approved condition as listed in the PMB care plan. My honest feeling is that Medshield is running around to buy time as to not paying the account.
HVDM
HENRY VAN DER MERWE's update06 Jun 2018, 14:21
Reviewer Update
Thank you Karin Binstead for sorting out this problem.