ROBBING MEMBERS ON CLAIMS

Been struggling to get my claim payed out since end of August 2018

I went to a Radiologist for a scan, OCSA Care approved and gave me a pre-auth code for my appointment. No problems with that.

Went for my appointment, had to pay the R800 cash upfront and claim back from OCSA. Did that and then put the claim in with OCSA. That is where all the problems started.

First they came back saying the Dr is not "registered" OCSA service provider. I then advised that when getting the pre- auth code the person never sadi anything about the Dr not being registered and that i was not able to go to that Dr. Then the invoices was a problem i had to get the Dr to re-invoice as they said the practice number was incorrect. Eventually my claim was processed and I was advised that it would be paid today. As per an email received from an agent on the 22/10/18 there is a R100 co payment with will be deducted. So the payment was to be done today and NOTHING received. I called in only for someone to tell me that the claim was processed and approved for R220 only when i asked why as that is not what i was told last week when i called in she said she will have to go and see why by looking through the account.

I have no clue what is happening at OCSA Care but the way they do business is pathetic. They have a call center where the agents are not allowed to call clients us as the member have to keep calling to follow up or send an email which they literally take DAYS to respond too.

MY CLAIM IS NOT PAID AND THEY ARE NOT ABLE TO GIVE ME ANSWERS. I AM OWED R700 AND ONLY WANTING TO PAY ME R220!!!!