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1 reviews | Active since Nov 2016

10 Sept 2019, 09:17

Reviewing of Co-Payments

I had a request to Medshield, directly emailed to the Operational Manager, Mr Richard Pea**** on 22 July 2019 in respect of having the Scheme review the co-payment on the Gastroscopy done 1 July 2019.( No reference number provided to me) I was admitted to Montana Hospital in Pretoria being sick and weak and put on a drip. The specialist decided to do a G-Scope as infection was found in my blood. I have emailed histology reports to Mr Pea**** 30 July 2019 and to date no further feedback received. Did few follow up emails and still no response.

I understand co-payments for G-Scopes and Colonoscopies,but in my case I was admitted as I was rrally sick and with the colonoscopy done 12/8/2019 a Grade4 internal haemorrhoids also had to be removed. Surely the Scheme can look at each case differently?? Why must I email a dispute to relook at the co-payments and not receiving any further response, not even a response to ask to maybe address it with the Fund Manager or Principal Officer.

I really hope Medshield will now look into my enquiry and provide me with positive feedback.

My member number is ***

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Replies (2)
Medshield
Medshield's reply10 Sept 2019, 13:11
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 reply30 Sept 2019, 13:27
Official
Good day 
Please be advised that your request has been sent to the medical advisor for review .However, the treatment has been considered as a non-pmb .
As a result the co-payment will remain applicable as per scheme rule. 
We trust you find the above in order.

Yours sincerely,
Medshield