AP
Adalia P
1 reviews | Active since Sept 2017
27 Jun 2023, 20:50
Gap shortfall
700% Gap however claims are not paid in full due to provider’s billing codes that are not fully covered, Gap literally paid 500% of my claims for 2 of my providers leaving me to pay the shortfalls, utterly disappointed
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Replies (2)
Total Risk Administrators's replyOfficial
28 Jun 2023, 06:40Good Morning Adalia. Thank you for your review and feedback. We are sorry to hear that your experience hasn't been a positive one. Please allow us to investigate and come back to you. Regards. TRA Management.
Best regards,
Total Risk Administrators's reply28 Jun 2023, 06:40
Official
Good Morning Adalia. Thank you for your review and feedback. We are sorry to hear that your experience hasn't been a positive one. Please allow us to investigate and come back to you. Regards. TRA Management.
Best regards,
Total Risk Administrators's replyOfficial
28 Jun 2023, 08:07Good day Mrs Pillay
We apologize for any confusion regarding the payment. After reviewing your account, we found that the doctor charged significantly higher than the medical aid rates for the procedure.
Please note that the second provider's services were fully covered by TRA, and there were two tariff codes that were also covered in full by your medical aid. However, consultations in a doctor's rooms are not covered by our policy.
To provide more information about the payment shortfall, our team will contact you by phone.
TRA Management
We apologize for any confusion regarding the payment. After reviewing your account, we found that the doctor charged significantly higher than the medical aid rates for the procedure.
Please note that the second provider's services were fully covered by TRA, and there were two tariff codes that were also covered in full by your medical aid. However, consultations in a doctor's rooms are not covered by our policy.
To provide more information about the payment shortfall, our team will contact you by phone.
TRA Management
Best regards,
Total Risk Administrators's reply28 Jun 2023, 08:07
Official
Good day Mrs Pillay
We apologize for any confusion regarding the payment. After reviewing your account, we found that the doctor charged significantly higher than the medical aid rates for the procedure.
Please note that the second provider's services were fully covered by TRA, and there were two tariff codes that were also covered in full by your medical aid. However, consultations in a doctor's rooms are not covered by our policy.
To provide more information about the payment shortfall, our team will contact you by phone.
TRA Management
We apologize for any confusion regarding the payment. After reviewing your account, we found that the doctor charged significantly higher than the medical aid rates for the procedure.
Please note that the second provider's services were fully covered by TRA, and there were two tariff codes that were also covered in full by your medical aid. However, consultations in a doctor's rooms are not covered by our policy.
To provide more information about the payment shortfall, our team will contact you by phone.
TRA Management
Best regards,