AS
Ahmed S

1 reviews | Active since Nov 2023

15 Feb 2024, 11:18

Service providers threatening legal action due to unpaid claims

I was hospitalized on 4th/5th December 2023 and Sizwe has still not paid a portion of the medical bill, which amounts to close to R20 000, when this was an authorized procedure, they initially stated that the ICU stay was not sent to them, which the hosptial accounts department has corrected and sent to them, contacting them has been a fruitless exercise as they keep giving me reference numbers, and stating the claim is being investigated. i even had net care accounts department contact them but to no avail, they keep mentioning their EDI system is offline for payment and they have a backlog processing. Not acceptable.

Then there is my Lancet account of R2000 or so, which is still unpaid, and these bloodtests were done IN HOSPITAL. not sure why????

medial aid number ***2 reference no for Netcare hosptial: ***

reference nos for lancet

0
Replies (2)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply15 Feb 2024, 11:40
Official
 Dear Ahmed,

Thank you for submitting the query, we sincerely apologise for the inconvenience caused. 
Thank you for the provided information. Kindly note that we are working on your query, and feedback will be provided as soon as it is available. 

Sizwe Hosmed team 
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply16 Feb 2024, 09:30
Official
Dear Ahmed, 

Update on the query: Kindly note that the claim has been reprocessed for payment. 
The member and the provider will receive statements as soon as they are available. 

The query is closed. 

Sizwe Hosmed team.