PB
Peter B

1 reviews | Active since May 2018

19 Dec 2023, 16:50

Claim dispute

My mom who is 80 spent 10 days in hospital and in ICU the Olivedale clinic account was short paid because of a pace maker authorization. This was finally sorted out by myself. However there is still a shortfall of R400. I have left messages for supervisors to call me. But they don't. I have sent over 6 emails to all the departments. Queries @sizwe, Case manager email and CMS queries. What more is a person supposed to do. There are 3 items that were rejected. And when I call them they put me on hold for 44 minutes at a time only to tell me that the supervisor will call me back. No call back received. This should all have been paid as it is a PMB condition. The member does not have a network option either. I will now be going to the Medical schemes council to fight this. This is a account from July 2023.

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply20 Dec 2023, 14:19
Official
 Dear Peter,

Thank you for submitting the query, we sincerely apologise for the inconvenience caused. 
We will be in contact with you to resolve your complaint. 

Sizwe Hosmed team