TN
Tyrone N

1 reviews | Active since Oct 2009

02 Mar 2016, 08:48

Straight Forward Claim equals Medshield Blunder!

Hi,<br> <br> I went in for a major sinus op with Dr van der Nest on the 17th Feb. Everything was authorized for the operation codes with Medshield before. I got an email from Medshield informing me that some of the codes were rejected with the following message -> 40 - Claim incorrectly coded by healthcare provider. Amended claim needed and 139 - Associated service/modifier has been rejected <br> <br> I have confirmed with the Doctor's account manager that all the correct codes were submitted as per the authorization. The Doctors account manager contacted medshield this morning to find out what was going on and she was told the automatic claim processing system made a mistake she must resubmit. Ref number: 020316QNOGPH<br> <br> I find it completely unacceptable that a straight forward claim from the doctor with matching codes submitted during authorization cannot be processed correctly the first time around. Please sorted out this claim immediately!<br> <br> Thanks<br> Tyrone Nel <br> <br>

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Replies (1)
Medshield
Medshield's reply02 Mar 2016, 09:27
Official
Hello tyronenel,

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