SvdS
Stefan van der Spuy

1 reviews | Active since Dec 2012

25 Mar 2024, 14:32

Poor service delivery rife in medical and other private sectors

There are just so many things to complain about today. My most recent experience (ongoing) is with my medical aid and in fact the entire private medical industry. After a routine colonoscopy at Kloof hospital on 5 March 2024, my problems started when I started to claim the shortfall on the anaesthetist account from my Gap cover. It turned out that Profmed totally overlooked two claim amounts on the anaesthetist account. They claimed that they never received the claims for the two items, yet the anaesthetists issued one statement with 4 items on it, each with its own code! I can go on and on. Kloof mediocre at best, documentation is duplication after duplication. I have spent hours sending and receiving e-mails, and spent a fortune on air time. Every time you call a service provider, you have to go through the motions of name, ID, etc, etc. So a second claim was submitted (today 25 March) to Profmed. And the doctors want their money, no concern on how you are doing.

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Replies (1)
Profmed Medical Scheme
Profmed Medical Scheme's reply26 Mar 2024, 09:09
Official
Hi Stefan, we are so sorry about your experience. Thank you for bringing this to our attention. We will pass your details on to our team and one of our consultants will reach out to you to discuss this further.