1 reviews | Active since Feb 2013
Wellness and Preventative Care Benefit ?
<p>I received a sms from Medshield on Monday 1 February 2016 at 13:26 stating the following:“The Medshield’s Wellness and Preventative Care Benefit is your first step to evaluate your health risk and quality of life. One Health Risk Assessment is offered annually on all Medshield options and to all beneficiaries over the age of 18 years. Visit either your GP, Pharmacy or through our Medshield Corporate Wellness Day programs for your test. If you have questions or need more information please call our contact centre on ********** ”</p> <p>I phoned your contact centre to verify the contents of this message and specifically asked if the assessment will cover the cost of the GP and the blood tests. I was advised that I do not need pre-authorisation and that the supplier was to submit the claim to Medshield.</p> <p>One of my family members went for this health assessment in July this year. Now Medshield refuses to honor their promise. After numerous emails and conversations with the contact centre, I have now finally given up. Nushard has managed to wear me down through red-tape and giving me the run-around constantly. My advise to others - avoid Medshield's promises and stick to the basics. Alternatively, look at other comapnies willing to honor their promises. Ignoring the customer and hoping that the problem will go away does not solve the problem...</p> <p> </p>
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
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
...and Medshield's reply:
Good day
With reference to your enquiry regarding: 181116Q0Z5GS
Membership number: ***
Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.
With reference to your health risk assessment performed on 4 July 2016.
Kindly note, as per scheme records the only account we have is from Drs Malan Louw And De Bruyn Inc. (practice number ********** ) for treatment date 04/07/2016 for dependent Anelda.
Please be advised the above account is for a normal GP consult whereby the doctor did not claim for the health risk assessment.
The health risk assessment includes the following testing's: cholesterol, blood glucose, blood pressure and body mass index (BMI)
A GP needs to claim for tariff code 07343 for a health risk assessment, which is payable from your wellness benefit.
We trust you find the above in order.
On behalf of the Scheme, I unreservedly convey our apologies to you for any misunderstanding, frustration and inconvenience experienced.
We would further like to provide you with assurance of Medshield's commitment to improved service delivery as you are an important partner to our Scheme.
Should you require any further assistance please contact the Medshield Medical Scheme Contact Centre on ********** .
My reply:
Please look at the attached claim for the blood tests that was requested by the doctor for the health assessment. This claim was also rejected by Medshield. You are now requesting your members to ensure that the doctors claim against specific ICD10 codes. None of your members have any control over these – now you reject the claims based on that? Surely this cannot be left up to your paying members to sort out?
I do not find this reply acceptable, it is the same run-around and red-tape that I have experienced all along while dealing with Medshield.
...and Medshield's reply:
Good day
With reference to your enquiry regarding: 181116Q0Z5GS
Membership number: ***
Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.
With reference to your health risk assessment performed on 4 July 2016.
Kindly note, as per scheme records the only account we have is from Drs Malan Louw And De Bruyn Inc. (practice number ********** ) for treatment date 04/07/2016 for dependent Anelda.
Please be advised the above account is for a normal GP consult whereby the doctor did not claim for the health risk assessment.
The health risk assessment includes the following testing's: cholesterol, blood glucose, blood pressure and body mass index (BMI)
A GP needs to claim for tariff code 07343 for a health risk assessment, which is payable from your wellness benefit.
We trust you find the above in order.
On behalf of the Scheme, I unreservedly convey our apologies to you for any misunderstanding, frustration and inconvenience experienced.
We would further like to provide you with assurance of Medshield's commitment to improved service delivery as you are an important partner to our Scheme.
Should you require any further assistance please contact the Medshield Medical Scheme Contact Centre on ********** .
My reply:
Please look at the attached claim for the blood tests that was requested by the doctor for the health assessment. This claim was also rejected by Medshield. You are now requesting your members to ensure that the doctors claim against specific ICD10 codes. None of your members have any control over these – now you reject the claims based on that? Surely this cannot be left up to your paying members to sort out?
I do not find this reply acceptable, it is the same run-around and red-tape that I have experienced all along while dealing with Medshield.