BAD SERVICE-JOIN THE SCHEME AT YOUR OWN RISK

Sizwe Hosmed Medical aid scheme

It all started when my husband was admitted in Montana Netcare Hospital in September 2022 Thank God that the hospital saved his life, and he got discharged.

On the 25 January 2024 , we received summons from the sheriff stating that we owe Montana hospital R59,981.75 Immediately we contacted the hospital and we were advised that our account is handled by Kholeka -Debtors controller

Kholeka provided us with all the information we needed, to be able to follow up with the medical aid.

Now the nightmare begins with Sizwe Hosmed Medical aid

We called the call center and stated the matter, they advised me that the matter will be send to ***, nothing happened until we decided to email the query ourselves on the 12 March 2024,Only to get an automated response stating solution will be provided 3-5 Working days.

Unfortunately I was admitted in hospital for weeks, and we did not follow up BUT Kholeka kept on trying with no Joy

On the 6 May 2024, Kholeka send an email to claims department still no response. ***, then sends an email on the 31 May 2024 stating that the issue has been resolved, i called the hospital to confirm, unfortunately it was not true, A big company like Hosmed, lying to its customers.

On the 10th of June ,i was asked to re send the invoice/statement which i did send to them. We then decided to go to the Hosmed branch in Pretoria-Tramshed on the 27th June 2024 where we spoke to a lady called ROSINA- She requested all the documents that we already submitted, and we comp****-she promised to give us feedback.

Rosina only came back to us on the 21 August 2024 requesting more information which we obviously submitted.

Rosina send same information to different people from claims department, then Thandi Ntisa from the same department advised that all is in order and explained everything Rosina and requested Tshidiso Pelo to assist further.

The matter was then forwarded to Dumisile Gwala,then ,Dumisile forwarded to Leslie Tarr, Leslie forwarded to Cecilia Higgins,nobody was attending to this query. 25 September 2024,Rosina advised that she send the matter to the administration department and spoke to Palesa reference number N***.

On the 04 October 2024, Lorraine requested information from the hospital and Kholeka responded on the 07 October 2024 , till then no feedback from Lorraine We feel ****** because we are paying R7000 to the scheme yet we are not treated fairly, now the hospital wants to lift a judgment against our names