bM
bongiwe M

1 reviews | Active since Feb 2015

04 Apr 2016, 10:36

Claim Payment

I submitted claim on the 24 February 2016 after seeing the specialist on the 23 Feb 2016. On the 16 I resubmitted the claim reason being I was told after making a follow up that the 1st was rejected because it didn't have diagnostic code and was told it will be processed within a week. I made follow up on the 22 March and I was told it was still being processed. I phoned again on the 29th and again I was told by call center agent that it was being processed. I phone again today 04 April and again I am told it is still being processed. My question was, how long does it take for claim to get processed and she said it takes a week. For mine it is going to a second month. I don't understand why is it difficult to pay claim when they get contribution on monthly basis without any delays. This is really not acceptable, you also don't even get feed back, you must keep phoning to make follow up. Where is customer service in that?

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply11 Apr 2016, 09:21
Official
Hello Bongiwemb,

We would like to apologise for your recent sercive experience with Sizwe.

Your case will be handed to one of our specialised Care Consultants we will contact you shortly to resolve your query.

With Care

Sizwe Medical Fund