SK
Shannon K

1 reviews | Active since Apr 2021

27 Feb 2023, 10:31

Mr Kammies

Currently out of words for sizwe I have it in black and white which I Wil now have to post in a newspaper regarding 3sixty health who has taken over the maternity benefits with sizwe and I mean I have been given the run around this whole time when they knew they are responsible for the benefit back and fort been pushed with enablemed now they went and paid a gynecologist who was paid and I told them again but the bloods whom the benefit shows is covered and was requested by the gynecologist has been paid 500 where the account is 2100 and they go pay 1200 twice I really don't know what to say and think I have notified the council for medical aids agian about this

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Replies (5)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply27 Feb 2023, 10:52
Official
Dear Shannon, 
 
Thank you for submitting the query, we sincerely apologise for the inconvenience caused. We will be in contact with you to resolve your complaint. 

Sizwe Hosmed team 


SK
Shannon K's update27 Feb 2023, 13:22
Reviewer Update
How the hell do you pay a doctor we spicifically told sizwe the gynecologist we saw does not deliver babies anymore and we need a new one and we got one and phone if we need a new authorization number they said no, and the new gynecologist got authorization for the delivery already so how the hell can you go pay the gynecologist we saw once and change you go pay that doctor over R2000 when she has already been paid and we are not seeing her but my current gynecologist is not paid and the bloods is not R500 on my miternity registration it' shows 0% Co paymen the people responsible is Loraine en dineo shuping I have send this info to the counsil for medical aids and to legalwise now i sould place this in the newspapers also
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply27 Feb 2023, 16:31
Official
Dear Shannon, 

The claim was paid and the remittance was provided to the provider as proof of payment. 
You were also Cc'd on the email for proof of communication. 

The query is resolved and closed. 

Sizwe Hosmed Team. 
SK
Shannon K's update28 Feb 2023, 10:32
Reviewer Update
I think you must think about going back to just sizwe, and leave this in between companies our because I have been send now statements of proof of payments of the unpaid claims who has been paid, the gynecologist who has been paid in January and again now the same amount in February because of not listening when I said she has been paid it's the bloods that send send us for that has been sort paid only R528 and the gynecologist is sitting with another R1300 after she was paid and I told them everything is up to date according to the statements I have since send to the counsil for medical aids, and I told dineo shuping all outstanding is paid according to proof of payments, so why is that doctor sitting with another payment when the bloods are not paid yet as I said 3sixty health is responsible for miternity benefit as it states on black and white in my possession all I'm saying my wife's health means more to me now since this is so stressing and I take the responsibil party in question responsible because that doctors rooms said this morning clearly a few people does not know what they are doing on the job
SK
Shannon K's update02 Mar 2023, 09:55
Reviewer Update
I really can't believe when there is and amount outstanding on the bloods of the test referred from the gynecologist of the 4th October and 3sixtyhealth go and pay the gynecologist another R1200 knowingly the secretary confirmed they had paid the same account again and dineo shuping and Loraine is the ones involved here what is going to be done now? Everything it seems to be sorted but the bloods which authorization we had for that day