MF
Michaela F

1 reviews | Active since Jul 2023

05 Jul 2023, 09:31

Use of bundled tarrif codes vs unbundled tarrif codes medical aid

I've been struggling endlessly with getting my account settled. From phone calls to emails with a dead end (no replies or responses) . One of my beneficiaries were admitted to trauma. Bloods were taken by pathcare. My medical aid covered most of the cost, but rejected one blood test due to a bundled tarrif code being used. I then contacted my medical aid who advised me to contact pathcare and ask them to unbundle the tarrif code as my medical aid option pays for each test individually and not bundled, by doing so the medical aid will then pay for tests. Upon calling pathcare it is been said to me that my query will be escalated to the claims department. Weeks go by no feedback. Upon emailing I am told tarrif code can't be unbundled, which I feel is very unfair, as should the tarrif code be unbundled my medical aid will pay the for tests which are on their list. Now I am billed for test covered by my medical aid due to a bundled tarrif code used.

0
Replies (2)
Pathcare
Pathcare's reply05 Jul 2023, 14:12
Official
Dear Michaela Fabre

I will investigate all your concerns raised and will revert back to you as soon as possible

Sharon van der Berg
PathCare Debtors 
Pathcare
Pathcare's reply12 Jul 2023, 09:39
Official
Dear Michaela

I trust based on the feedback and conversation had with our accounts team leader that resolution is on the way.

Yours sincerely
Sharon van der Berg
PathCare Debtors