Absolute Nightmare

<p>On 29th April 2013I was taken to the to the casualty ward at the Glynnwood hospital. My brother filled out all the forms and used my medical aid details. My brother was told that because they didn't know what was wrong or if I had taken any substances (which I hadn’t) they needed to take blood, which they did (I don't remember much of this).</p> <p> </p> <p>The medical aid denied authorization to be admitted to the Glynnview so I was taken to a GP and referred to JHB Gen.</p> <p> </p> <p>I left the company I was employed by in May 2013 and the medical aid was then terminated, back dating to 30th April 2013.</p> <p> </p> <p>Earlier this year (2016) I got traced and issued a summons for an outstanding bill from Vermaak and Partners pathologists through their attorneys (Viljoen Attorneys) (with interest and tracing fees etc) for R 7574.70 of which R 4726.30 was the original bill for the blood tests. I have no witnesses to this but when the summons was brought to my NEW work place, it was mentioned in front of people and when we went outside I was asked to sign the document as proof of delivery which I later realized was an acknowledgement of debt form. The person did not have a document manifest for me to sign. Very sneaky and unprofessional.</p> <p>.</p> <p>The invoice for the blood tests was made out to me as a private patient and was for R4726.30. I queried with the medical aid and they said they couldn't see a claim for blood tests but after querying with the medical aid a few months later and speaking to someone else they found that the claim was submitted for treatment on the 29th April 2013 for the amount of R2820.20 and was rejected initially because of lack of funds (which was found to be an error on their side and was resubmitted in August 2016) and then because of an incorrect reason code (They were informed I was admitted when I wasn't) and they didn't pay because there was no authorization code. After a lot of fighting from my side, the medical aid paid out R2411.78 to the attorneys acting on behalf of Vermaak and Partners. I had to call them and make sure they had received the payment and ask for a statement. According to them I'm still liable for R3526.12. I've been paying R250 pm (R1750 so far) and they've received R2411.78 from the medical aid. When I contacted the pathologists they denied ever sending a claim to Bonitas (telephonically and via email) and at first said they never had my medical details but later retracted that statement and then their lawyer confirmed on email that they actually did send a claim but it was rejected and I was told I was put on as private because my medical aid had been terminated (but it was terminated the day after the treatment so that still doesn't make any sense). </p> <p> </p> <p>When I challenged them via email (doctors and lawyers), they cannot give me a straight answer as to why there are 2 invoices using 2 different practice codes with 2 totally different amounts.</p> <p> </p> <p>What I really believe is that they have taken a big chance and invoiced me R1906.10 more as a private patient and when the medical aid paid out 3 years later they've been caught out because the amount was actually for R2820.20 and NOT R4726.30.</p> <p> </p> <p>I got a very quick response via email from the attorneys saying that the bill was correct but when I rep**** asking why the original claim was for R1906.10 less there has been nothing but silence.</p> <p> </p> <p>I am going to be taking this up with the industry specific ombudsman; however, as part of the procedure they recommend that a person tries to resolve this with the service provider before approaching them. Obviously I’m getting no joy.</p> <p> </p> <p>I would like some with authority from Vermaak and Partners as well as from their attorneys, Viljoen Attorneys, to review my case and give me some answers. I do not want to deal with the people I’ve had correspondence with; I want to deal with their supervisors.</p> <p> </p>