SS
Shadreck S

1 reviews | Active since Jun 2024

26 Jun 2024, 21:43

Non Payment of PMB and Pre-auth claims

I'm utterly disgusted in the level of incompetence and dishonesty that I have experienced dealing with Sizwe Hosmed's staff.I have been waiting for payment for a pmb claim for services rendered under auth to be paid out since March . After multiple promises on email from Tshepang and Queeneth that payment will be made on "the next payment run" I have not been paid yet instead they are now ignoring my emails and dropping the call when I call the call centre. I have been to the offices in Houghton and I'm constantly being told different stories and yet again led to believe that the issue is being escalated and marked as urgent for "KOH".I have reached the point where I will no longer be accepting pre-auths from Sizwe because the medical aid does not honour them. I would strongly advise that members reconsider being part of the scheme because many healthcare providers are becoming reluctant to accept this medical aid. Please report any related issues to the ombudsman so we can resolve this.

0
Replies (3)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply27 Jun 2024, 08:46
Official
 Dear  Shadreck, 

Thank you for submitting your query and apologies for the inconvenience caused. 
Kindly provide the query's reference numbers, and we will investigate and escalate the query for urgent attention. 

We appreciate your patience.  

Sizwe Hosmed team. 
SS
Shadreck S's update27 Jun 2024, 09:59
Reviewer Update
***
***-***- ***1-pls review mm was in hosp auth avail
Auth- NEO***A
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply27 Jun 2024, 10:04
Official
Received with thanks, Shadreck. 

We will provide substantial feedback.