FM
Fusi M

1 reviews | Active since Oct 2020

30 Oct 2020, 11:08

ABSOLUTE TSOTSI'S

Sizwe has been the worst thing for me besides COVID-19 this year. First I took my wife for a scan at a Radiologist with a Dr's referral letter and they refused to pay. Then my wife got pregnant, registered her on the Maternity benefit(sent us all the goodies).Got a refferal to see a Gynae, they never paid for all the gynae's visits. Gave them a call, I was told I was supposed to have got an Authorisation from Enablemed(something I have never heard of before). And on their Brochure there is absolutely no mention of Authorisations before visiting any Specialist(as long a you have a referral from a GP).

Now Im sitting with a Pile load of Bills from Providers demanding their Money that i do not have and i am expecting a child. So Sizwe really let me down.

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Replies (2)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply30 Oct 2020, 11:25
Official
Dear Fusi,

We acknowledge receipt of your comments. One of our consultants will contact you shortly to assist with your query.

With care,
Team Sizwe
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply30 Oct 2020, 13:48
Official
Dear Fusi

Apologies for all the inconveniences caused

We have been advised by Enablemed that the previously rejected claims have been settled up to the Scheme Rate, a statement of those previously rejected claims has been shared and you will receive it shortly.

With care,
Operations Management Team