Putrid service from Sizwe Hosmed

I phoned the Sizwe Hosmed call centre yesterday with my query regarding short payment of my Lancet Claim, after several queries by email. The service given to me as a member was NOT satisfactory.

The reference number given to me at the end of this call is N***. I spoke to Precious. The outstanding amount of R140.00 was not paid, apparently the benefit was exhausted. I told her it was for my diabetes and was requested by my Diabetologist. It should pay as a PMB claim. She asked me the date of service, then told me it is a stale claim. I said the claim is dated 22/07/24, that it is not a stale claim and the original claim was received and part paid, that I had queried this before, but received no final response or closure. She then insisted that I give her the WF reference numbers of all my queries. I told her I was not at my laptop and it will take a while, asking her if she could call me back. She said she cannot call a member back. So, I asked her to wait while I do this. ( In the past I have run out of airtime whilst I am querying something and put “on hold” , while the agent goes off to collaborate with a colleague ). So, it is okay for members to run out of airtime but not for the medical aid to offer a courtesy to call their member back. Nonetheless, she confirmed the claim has been sent off for payment as a PMB. Then she asked me if I have any other query. I said yes, I do and continued to discuss my query. She stopped me, saying she cannot help further as her time limit is exceeded. It’s been 14 minutes already! She will transfer me to another agent! Now, I must repeat all my details to the “new” agent. Then wait for them to get my records up on their system, etc. I had never heard of any company that gives you service in this manner! I was so flabbergasted with this response, I ended the call.

I have emailed the balance of my query to Sizwe Hosmed relating to 2 short payments for 2 service providers. I attached some of the queries over the past year, not all the reference numbers are attached though. We were on another Option in 2023 and did not have any issues in the past years.

Service Providers have also been querying these short payments regularly. And they are now frustrated with no closure and have turned to me, the member to pay the shortfall.