TT
Tebogo T

1 reviews | Active since Jul 2011

01 Jun 2017, 13:42

What's the point of medical aid really???

<p>I have just had the most unpleasant experience with Medshield trying to get pre authorization for a procedure that has to happen in hospital tomorrow. I've been informed the scheme needs 72 hours before they can do authorization and I in the meantime have to pay R5000 cash to get it done in hospital. Really? What's the point of medical insurance if they can't help in case of an emergency? I'm disappointed </p>

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Replies (2)
Medshield
Medshield's reply02 Jun 2017, 07:17
Official

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

Medshield
Medshield's reply02 Jun 2017, 09:33
Official

Good day

With reference to the said hospital authorisation, the Scheme received the pre authorisation request on 01/06/2017 which was pended for a non-disclosure process that needs to be followed. It should be noted, for any member/s that have joined the Scheme within the last 12 months, a non-disclosure process is followed. This is a standard process for all authorisation requests for members that are on the Scheme for less than a year. An investigation into a non-disclosure does not imply that your authorisation will be declined.

Kindly note, our hospital department MSO (Medical Services Organisation) is awaiting the medical records from your treating doctor. Once this has been received and reviewed, then will the authorisation be approved / declined in accordance to scheme rules.

We trust you find the above in order.

Yours sincerely

Medshield