BD
Brigitte D

1 reviews | Active since Mar 2018

01 Jun 2022, 09:43

Knees to Back Breaking Fees

I am on my husbands medical aid, Sizwe Hosmed Plus. On the 01 July 2021 I went into hospital for a knee operation. I received a pre authorization number fo=rom the medical aid. I received a call from the hospital saying the had not been paid. I was then in contact with hospital claims at Hosmed and advised that the incorrect code was sent with the authorization for one day only and that an amended extension stay code was to be sent to medical aid so they can make the additional payment. I got another reference number. The orthopedic surgeon then sent a motivation for my extended stay. I was in hospital for 3 days instead of one. The medical aid confirmed that they received the letter of motivation. My case went under investigation. Medical aid had paid R30k for two days. The letter of motivation was for an extension of one more day. I was then informed that medical aid reversed the entire payment and sent it to their billing department to investigate. It is now 01.06.2022 almost a year later and this has still not be resolved. The R11k for the extra one day I stayed has now accumulated to R40K ( the full 3 days) .

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Replies (2)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply01 Jun 2022, 10:07
Official
Dear Brigitte,

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

Your Choice for Quality Care, 
Team Sizwe Hosmed
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply26 Sept 2022, 15:06
Official
Dear Brigitte, kindly note that the claim was paid. 

Sizwe Hosmed team.