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CURNEL A

1 reviews | Active since Sept 2020

18 Feb 2022, 07:24

This is a bad collaboration with Sizwe and Hosmed

This is a bad collaboration with Sizwe and Hosmed, they still the same and dont attend to they paid consumers, Its now two weeks since I lodge this complain with them but still today no one come back to resolve this matter, they only reply on Hello Peter that they will attand to this complain but never.

Good Day All Trust this mail finds you well. Can you please assist by correcting the attach statement of my child Lakeview Hospital bill whereby it noted to Members Liability with a reason code od 86007 ( Treatment in Private Hospital only payable if there is a approved pre-auth). I don't know is this the way the medical aid don't want to take responsibility for this emergency Hospitalization of my child and come up with this reason codes like this, because If I can notify you what happen on the 06 January 2022 is as below bullet points. Ambulance takes my child to casualties, I'm with my child and at Casualties the Nurse take my medical aid card and phone the medical aid for pre-authorization before they can start assisting her, I was standing with the nurse when she makes the call for pre- authorization. From casualties I was send to the reception to go and open a file for my child, at reception the admin Lady take the medical aid card and phone again for pre-authorization before she can open and admitted my child to a ward. At ward 12 at Lakeview Hospital, the nurses take my medical aid card again to confirm with reception about the admission and pre-authorization before they give her the bed. This is not the first time we use the medical aid at Lakeview Hospital because my child going there for treatment, they never make that mistake of not getting a pre- authorization first, they will send us to a government hospital If our medical aid never agreed to the pre-authorization, so please pay what is due to Lakeview Hospital.

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Replies (2)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply18 Feb 2022, 12:11
Official
Dear Curnel,

We acknowledge receipt of your comments. One of our consultants will contact you shortly to assist with your query.

With Care
Team Sizwe Hosmed 
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply29 Sept 2022, 11:13
Official
 Member has been assisted and query resolved. 

 Team Sizwe Hosmed.