TS
Tshepiso S

1 reviews | Active since Apr 2019

12 Apr 2019, 04:52

Unpaid Claim

I am so frustrated with Medshield!!! On the 14th of February 2019 my 5 month old child was admitted as an emergency in hospital while in Botswana, the hospital told me they do not accept SA medical aids, I called Medshield on the same day where a letter was sent to me confirming they will pay the hospital bill. Since this was an emergency, I was advised to pay cash (about R26300) and later claim from the medical aid. Biggest mistake ever!!!! It is now the 12th of April and even today I am still waiting for my claim to be processed. I have submitted all the required docs. Every time I call to follow up I spend almost an hour on the phone being sent from pillar to post. The Team Leader Debby from hospital authorization, handling my case, who is very rude and not customer friendly, keeps taking my number down and says she will get back to me. Even now I’m still waiting for her feedback. All I want is my reimbur*****t and to get better service for the amount I contribute towards the scheme. I am tired of hearing about the “IT dept, logging faults for practice number, authorization sign offs”and all other excuses I have been given. I guess this is why the hospital did not want to accept the medical aid, if I have to struggle like this as a member they would go through worse. Please Medshield finalise my claim, it’s been 3 months now!!!!!!!!!!!!

The reference numbers to my claim are: 150219Q82RB3 210219Q8D4NY 080319Q95XGS (And many others that I don’t have on hand right now)

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Replies (2)
Medshield
Medshield's reply12 Apr 2019, 07:07
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 reply13 May 2019, 15:22
Official
Dear Member, With reference to your enquiry dated 120419QBY973 Kindly be advised that the account from Bokamoso Hospital  , treatment date 14/02/2019, dependent Luthando Oneilwe has been processed to be refunded to you on the next payment run. Please note account detailed has been sent to your personal email address. We trust you find the above in order.

On behalf of the Scheme, we would like to unreservedly convey our apologies to you for any frustration and inconvenience that you might have experienced as a result of the poor handling of your enquiry. We would further like to provide you with the assurance of Medshield’s commitment to improved service delivery as you as the member is an important partner to our Scheme.  Yours sincerely, Medshield