Not fullfilling their obligation to the Service Provider

This is our second review with this scheme on the exact same matter for the exact same patient. We have emailed Dineo Shuping and Loyiso Nqeto at Sizwe on the 5th of April, complaining that the issue has still not been resolved and to date, WE HAVE NOT RECEIVED A REPLY OR A CALL BACK!!! Each and every person at Sizwe involved in 'solving' this problem should be taken to task including your capturing department. This is pure incompetence on the side of this medical aid. And due to this incompetence, the surgeon has still not been paid. We are preparing to take it to all social media platforms, the Ombudsman and the Council of Medical Schemes as you have not covered Dr for a service he has rendered to the patient in Dec 2022 even though we have provided all accounts via EDI and paper claims on numerous occasions. Please find the 1st post below.

"have posted An Orthopaedic account was submitted to Sizwe on the 5th Jan 2023. REF: WF**********5N**********1 This account is yet to be captured and paid even though Medx has queried this account on numerous times!! Spoken to a Hilda, requested to be escalated to Wandile (Team Leader) but she was unavailable, as aways. This is by far the worst Medical aid to deal with, the incompetency of the staff is unbelievable. In fact, personally, I have just terminated my fathers membership today. I will not recommend Sizwe to anyone. When is the account going to be paid????"