LM
Lesley M

1 reviews | Active since Sept 2016

02 Apr 2018, 14:51

Spectramed ********* in paying PMB conditions.

Spectramed has not paid an outstanding account where I had auth for the treatment and sent the account, but because they did not have the correct name of the member but instead "Baby" it was rejected. NO matter how many times I tried to call them or email them, I was not helped because their systems are constantly down and thus they are unable to help us. When I went to the CMS, I received a letter from spectramed stating they have paid the full account to another medical practitioner who had not seen the patient. AS I do the books for both practices I can state that no such money was paid into either accounts and there is no statement to prove that is had been paid. The member is not even prepared to pay her account and thus the one that loses out is the medical practitioner who has to work weekends, public holidays and after hours helping rude patients who are paying medical aids who are not prepared to pay their accounts. When we approach the CMS who is the correct channel to work through nothing is done and we have to wait months to get a simple thing resolved. But by this time the medical aid turns around and pulls the stale card. Anything not to pay a PMB condition which had authorisation. Why do we even bother to treat these patients. NO one cares, so maybe we should shun our ethical code we swore upon when we qualified and refuse to treat sick and dying patients. But then that would make us as bad as Spectramed and CMS.

0
Replies (0)