JS
Jostina S

1 reviews | Active since Jun 2024

19 Jun 2025, 14:40

3 months of unpaid claims

I have 2 claims for Drs visits that happened in March that have not been paid to date. I've been calling almost every week from April and I'm always being told it's escalated and the claim will be paid. It's gotten to a point where I'm getting emails from the Drs to settle the account since its past over due. I cannot even consult at the Dr when I'm sick because I am owing. What's worse is they made changes that we cannot consult directly with the Dr without first consulting on the App and failed to inform us. When I took my son and the claim was rejected that's when they informed us of the changes. *********** does not even begin to describe this medical aid. If I could give 0 stars I would.

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Replies (2)
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply19 Jun 2025, 16:29
Official

Dear Jostina,

Thank you for reaching out and sharing your experience. We sincerely apologize for the delays and the inconvenience this has caused you.

Please rest assured that a dedicated consultant has been assigned to your case and will be in contact with you shortly to provide a detailed update

Kind regards,
Umvuzo Health
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply23 Jun 2025, 12:37
Official
Dear Jostina

As discussed with one of our service consultants, please note that both of your claims were rejected as preauthorisation was required

However, for the gynecology-related claim, you were requested to submit a retrospective authorisation request. 

Kindly ensure this is completed at your earliest convenience to facilitate further processing.

Should you need any assistance with the submission process, please feel free to reach out.

Regards
Umvuzo Health