CP
Claudia P

1 reviews | Active since Oct 2024

05 Nov 2024, 07:49

Sizwe requesting given information and avoiding claim payment.

A few weeks ago, I complained about their total lack of communication and did receive some. But now I have a new complaint about shirking payment. I had to regularly attend a wound clinic from 7 August to 10 October, at least once a week, some times twice a week. Sizwe ignored my submitted statements until I started to throw my toys again and now (but only on the ONE statement) are sending Email after Email requesting information that is present on that one (of many) statement. They are procrastinating and obviously trying to avoid payment to me (the main member) by simply not doing their job and reading that one statement (they have requested ICD 10 code, service date, amount claimed, etc) which is all on that one statement, in fact it is on all the statements that I submitted in this regard, but they are only focusing on that one, making it a major, prolonged issue and headache.

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Replies (3)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply05 Nov 2024, 08:25
Official
 Dear  Claudia, 

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

We appreciate your patience.  

Sizwe Hosmed team 
CP
Claudia P's update25 Nov 2024, 17:14
Reviewer Update
Please note the date posted and as yet I have had NO FURTHER COMMUNICATION! Which again, brings me right back to my initial complaint of lack of communication. Loyiso did a 5 minute stint and then nothing and so this issue has still not been resolved (let alone in their 3 - 5 working days stipulation! What a joke!!). One lack of service exchanged for another...

CP
Claudia P's update29 Nov 2024, 17:12
Reviewer Update
Apparently I need to correct my complaint. It is not Sizwe as a whole entity that is ignoring me, it is apparently only the Claims department that is *********** and incapable of doing their job / respinding or communication. Oh! And communication between the various departments is too much of a schlep to ask, so I am expected to re-find all the associated claims and resubmit to Loyiso is the non-claims department so that she can help me (maybe, we have yet to see).