CK
Cleone K

1 reviews | Active since Jan 2017

18 Feb 2021, 00:28

Hospital auth pending after initially being approved

Good day,

I app**** to rejoin the medical aid and my application was accepted and i disclosed everything on my application .The membership department requested me to complete the section where i need to disclose and i disclosed my pregnancy and after resubmitting my application they approved.On the 16th i had a emergency c-section and i called for the authorization on the 17th and the consultant called the membership department and approved the authorization.I actually asked her to call me back once done communication with the membetship department but she never did .I only received an sms stating the authorization has been approved and a few hours down the line another sms stating the authorization is pending.When i called them they said the team leader need to look at it because its possible non disclosure.I've disclosed my pregnancy when i app**** and the consultant initially approved my authorisation. What is actually happening there .How can you approve an authorisation and then decide its pending?

I already gave birth and used that authorisation number at the hospital just for them to put it under pending.

Where do they expect me to get the funds to settle the bills.

Why did they approve the authorisation initially???

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply18 Feb 2021, 08:15
Official
Dear Sizwe member

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

With Care
Team Sizwe