RG
Rajen G

1 reviews | Active since Oct 2024

30 Oct 2024, 11:39

Sizwe hosmed incompence and total lack of care

3sixty is not reversing claims timeously. They do not ask all the questions in one email or telephone call. There is so much of tooing and froing. Extremely frustrating. Queries which are not answered in totality are not escalated. We,the members do not have access to team leaders or management... why!!!

Took us 3 months to reverse 2 claims. One claim has still not been reversed since July. Why does it have to be like this. We are trying to get back money for the medical aid and we are just shoved around. Most disrespectful. It reminds me of the service we get from the government departments... For my mind it looks like incompetence at the call centre. Since sizwe have taken over this medical aid is just going downhill. That is why it's under management and the principal officer is pleading with us to stay.

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Replies (3)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply30 Oct 2024, 11:42
Official
Dear Rajen, 

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

We appreciate your patience.  

Sizwe Hosmed team
RG
Rajen G's update30 Oct 2024, 16:52
Reviewer Update
Hello,

Please answer as to why we as members and owners of this medical aid cannot speak to team leaders and or managers. They are not demigods. The call centre staff 's don't care attitude is " call back next week to check on status" and then forget about the queries, because then someone else takes the call and we have to repeat the whole saga again. Extremely frustrating and time-consuming. You should have kpi's to determine what has not been resolved to rate staff. Why can there not be professional and effective responses. Do better! Also the durban office is unprofessional, unhelpful and severely lacks knowledge.
All the information from the doctor and us have been provided. Why can't this matter be escalated as a matter of course, programmatically and improved systems rather than us resorting to putting these frustrations on public platforms.
The ref nos are as follows:
Wf***0n***3
Wf***1n***3
Wf***3n***8
Wf***5n***6.
My wife has also called and was given these nos :
N***
N***
N***

I eagerly await your response.

Yours faithfully
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply01 Nov 2024, 09:15
Official
Received with thanks, Rajen.