SG
Shamz G

1 reviews | Active since May 2025

02 May 2025, 12:27

Mishandling of Medical Claims by Sizwe-Hosmed & 3Sixty Health

I am appalled by the incompetence and utter disregard for my well-being demonstrated by Sizwe-Hosmed & 3Sixty Health. The ongoing failure to resolve my hospital claims and specialist visits is completely unacceptable. Despite repeated attempts to get answers, I am met with delays, mismanagement, and blatant negligence, forcing me to escalate this matter immediately.

Here’s exactly why I am outraged:

Unacceptable Authorisation Delay: In September 2024, I was forced to endure FOUR HOURS of unnecessary delays in the hospital authorisation process while I was already unwell. Instead of proceeding with the pre-arranged hospitalisation as instructed by my doctor, I was forced to go through the emergency room, putting my health at further risk. To make matters worse, the authorisation was sent to the wrong hospital, causing additional chaos.

Extended Hospital Stay & Financial Burden: Due to the unnecessary stress inflicted upon me, my endocrinologist had to extend my hospital stay to five days. Not only has this negatively impacted my health, but I am now left with additional financial strain because of the reckless inefficiency of your team.

Failure to Pay Hospital Bills: Parklands Hospital has yet to receive full payment for my stay, and Netcare has now transferred the outstanding balance to collections. This is absolutely unacceptable. I have repeatedly disputed this bill and raised concerns, yet your failure to provide a proper resolution has put me at risk of financial hardship.

This situation has caused me immense distress, and I will not tolerate such blatant disregard for my rights and well-being. I demand an immediate resolution to the outstanding amount, along with a full explanation and accountability for this disgraceful handling of my claims.

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Replies (4)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply02 May 2025, 12:29
Official
 Dear Shamz,

Thank you for submitting your query, and apologies for the inconvenience caused. 
Thank you for the provided query reference number. We will investigate and escalate the query for urgent attention. 

We appreciate your patience. 

Your Choice for Quality Care
 Sizwe Hosmed team 
SG
Shamz G's update03 May 2025, 11:05
Reviewer Update
Hi Sizwe Hosmed is your reply automated?? I have send you my references pertaining to my matter as well as membership number yet have not received a response or call back.

Are you all just messing with us, your clients!!


Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply04 May 2025, 21:38
Official
  Dear Shamz, 

We are working on your query.
Feedback will be provided. 
SG
Shamz G's update06 May 2025, 12:35
Reviewer Update
How are you addressing my query when I haven't been contacted yet? What could possibly be so difficult to resolve regarding a straightforward in-hospital claim for which authorisation was approved? During every phone call I've made, I've been informed that the payments department is backlogged and that my account would be settled within 5 to 7 days. It is now NINE MONTHS LATER!!! I expect a phone call today!