MORE THAN A YEAR LATER AFTER SUBMITTING REPORTS AND ACCOUNT STILL NOT PAID

Practice Number *** Membership Number - ***2 Date of Service - 31/03/2022 Contact *** /*** Email ***

We app**** for PMB benefits the scheme keep on rejecting our PMB review requesting stating that this was a pre-booked case please take note the authorization was requested on the day of the procedure at 15:00 so how was it a pre-booked case.

Then they requested Radiology Reports that was send to them and even the Radiology Report confirming that it is indeed a PMB.

Since then we keep on following up on the account but just getting now where.

How long must we battle with Sizwe Hosmed to get accounts processed and paid ? Do Sizwe Hosmed think it is fair on their members ?

Ref Numbers there is plenty

WF***4N***; WF***5N***; N***; N***

Please urgently supply us with feedback regarding this else our next thing to do is to refer this to the CMS and request the member to settle in the meantime the account.