MB
Marileze B

1 reviews | Active since Dec 2012

08 Jul 2020, 10:19

Chronic medication payment not paid out

I've had it with Sizwe and their poor service! Since I joined Sizwe in March it's been a constant struggle to get proper customer service from them. (Membership nr: ***)

I went to Dischem Pharmacy on the 7th of May - my medication was flagged as Chronic Medication (Ref N681596 - talked to Grace). I requested the prescriptions (dated 12/12/2019) from Dischem and send it to Sizwe Chronic Medication as requested - they only wanted a copy of the prescriptions. They rejected it because they needed an ICD10 (F32.2) code which I provided. On the 15th of June my chronic medication was approved BUT the claim for the mediction that I purchased on the 7th of May is not being paid out to me because the chronic medication start date is the 11th of May 2020! Who decided that that should be the date if the prescription clearly states the 12 of December 2019? Now I'm being penalized and told that that amount will NOT be paid out to me!

Let me also make this very clear -NO ONE (accept the pharmacy) told me that the medication was flagged as Chronic. Only after the chronic medication was rejected on the 19th of May I was informed that they need an ICD10 code . NO ONE told me that I had to apply for chronic medication within 5 days! Am I suppose to smell these things. All I receive every single time when I sent an email to Sizwe is a stupid non informative response email that states:

Good day Valued Customer, We have attended to your call reference number: WF***3N*** logged on 2020-07-03 12:01:34. We are pleased to tell you that it has been resolved.

They don't say WHAT has been resolved or WHAT'S outstanding or HOW it's been resolved.

This is SUPER frustrating and the worse customer service I've ever received from ANY company.

0
Replies (2)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply08 Jul 2020, 10:46
Official
Dear Marileze,

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

With care,
Team Sizwe
MB
Marileze B's update15 Jul 2020, 13:38
Reviewer Update
Good day - I received a phone call from a gentlemen that promised to look into the matter. He promised to give me feedback - I'm still waiting for that feedback