PV
Petrus V
1 reviews | Active since Nov 2020
13 Nov 2020, 09:55
Medical aid reverse payments two month after payments was made to hospital and Dr.
Umvuzo paid cliam in July 2020 to the Hospitals and Dr I PJ Visser sow in begining of July 2020 when I was admitted to hospital. All authorities was given from umvuzo to hospital and dr. So now in September 2020 the medical aid reversed all claims **** in July as my previous employer Russell terminated my service and still paid them end of June 2020 for me to still be an active member on the medical aid till end of July 2020 I've been handed over to dept collectors. I try to get into contact with umvuzo but all failed. Emails send to them on ***. And thet just do not reply at all.
Please I need response from them. As I am currently not working. With a pending ccma case. And thr dept collector's is demanding full payment now from me.
Thanks PJ Visser medical aid membership number:153872
Helpful (0)
Replies (7)0
Replies (7)
Umvuzo Health Medical Scheme's replyOfficial
13 Nov 2020, 15:09Dear Mr Visser,
Thank you for the details supp**** of your case. We will forward it to the escalations department, and a consultant will get in touch with you to get further information.
Kind regards,
Umvuzo Health
Thank you for the details supp**** of your case. We will forward it to the escalations department, and a consultant will get in touch with you to get further information.
Kind regards,
Umvuzo Health
Umvuzo Health Medical Scheme's reply13 Nov 2020, 15:09
Official
Dear Mr Visser,
Thank you for the details supp**** of your case. We will forward it to the escalations department, and a consultant will get in touch with you to get further information.
Kind regards,
Umvuzo Health
Thank you for the details supp**** of your case. We will forward it to the escalations department, and a consultant will get in touch with you to get further information.
Kind regards,
Umvuzo Health
PV
Petrus V's updateReviewer Update
18 Nov 2020, 00:26Umvuzo called me back and try to explain to me why the reverse the claims of begining of july 2020. I asked them to why did they give the pre- authorisation to the hospital, if my membership as terminated. They reply that i was still an active member at that time. So it means then the cliams should not have been reversed! They now come with a lot of stories to put blame to someone ells. The point of the matter stays, my membership
PV
Petrus V's update18 Nov 2020, 00:26
Reviewer Update
Umvuzo called me back and try to explain to me why the reverse the claims of begining of july 2020. I asked them to why did they give the pre- authorisation to the hospital, if my membership as terminated. They reply that i was still an active member at that time. So it means then the cliams should not have been reversed! They now come with a lot of stories to put blame to someone ells. The point of the matter stays, my membership
PV
Petrus V's updateReviewer Update
18 Nov 2020, 00:33was still active and the pre-authoration was given and they need to pay the claims for that. As this was not a mistake I have made. Also they say I resigened from my former employer. Thats not true. And no notice of termination was given to me by they. So they have to pay.
Hope they will come to tirms and pay the claims again they reversed. As they gave authority.
As they did not follow there own rules.
Thanks
Pieter
Hope they will come to tirms and pay the claims again they reversed. As they gave authority.
As they did not follow there own rules.
Thanks
Pieter
PV
Petrus V's update18 Nov 2020, 00:33
Reviewer Update
was still active and the pre-authoration was given and they need to pay the claims for that. As this was not a mistake I have made. Also they say I resigened from my former employer. Thats not true. And no notice of termination was given to me by they. So they have to pay.
Hope they will come to tirms and pay the claims again they reversed. As they gave authority.
As they did not follow there own rules.
Thanks
Pieter
Hope they will come to tirms and pay the claims again they reversed. As they gave authority.
As they did not follow there own rules.
Thanks
Pieter
Umvuzo Health Medical Scheme's replyOfficial
18 Nov 2020, 05:21Dear Pieter,
The last contribution received from you (your employer) was end of June, for the month of June. You need to bear in mind that you pay your contributions in arrears, in other words you pay for the month of July at the end of July. The services you received were in July and the payment also in July. However after not receiving any payments from you from the month of July onwards, the Scheme had no option but to reverse the payments, since no contributions have been received ever since.
As the client services manager explained to you, if you can pay your contributions from the month of July until November, the Scheme will reinstate your membership and pay for services incurred in this period.
Kind regards,
Umvuzo Health
The last contribution received from you (your employer) was end of June, for the month of June. You need to bear in mind that you pay your contributions in arrears, in other words you pay for the month of July at the end of July. The services you received were in July and the payment also in July. However after not receiving any payments from you from the month of July onwards, the Scheme had no option but to reverse the payments, since no contributions have been received ever since.
As the client services manager explained to you, if you can pay your contributions from the month of July until November, the Scheme will reinstate your membership and pay for services incurred in this period.
Kind regards,
Umvuzo Health
Umvuzo Health Medical Scheme's reply18 Nov 2020, 05:21
Official
Dear Pieter,
The last contribution received from you (your employer) was end of June, for the month of June. You need to bear in mind that you pay your contributions in arrears, in other words you pay for the month of July at the end of July. The services you received were in July and the payment also in July. However after not receiving any payments from you from the month of July onwards, the Scheme had no option but to reverse the payments, since no contributions have been received ever since.
As the client services manager explained to you, if you can pay your contributions from the month of July until November, the Scheme will reinstate your membership and pay for services incurred in this period.
Kind regards,
Umvuzo Health
The last contribution received from you (your employer) was end of June, for the month of June. You need to bear in mind that you pay your contributions in arrears, in other words you pay for the month of July at the end of July. The services you received were in July and the payment also in July. However after not receiving any payments from you from the month of July onwards, the Scheme had no option but to reverse the payments, since no contributions have been received ever since.
As the client services manager explained to you, if you can pay your contributions from the month of July until November, the Scheme will reinstate your membership and pay for services incurred in this period.
Kind regards,
Umvuzo Health
PV
Petrus V's updateReviewer Update
17 Feb 2021, 23:54I do understand what you are saying. Why must I pay from July till November? Also I did not know about the thing that month in areas thing. Secondly if you declined all admissions for July as you should have or notifed me in July or even August that you are waiting for payment. This wouldn't have been an issue now. So I am willing to pay for July only so that you can reinstate and pay all the medical expenses that was pre-authorized by you in July 2020 and reversed, as you did not get payment.
PV
Petrus V's update17 Feb 2021, 23:54
Reviewer Update
I do understand what you are saying. Why must I pay from July till November? Also I did not know about the thing that month in areas thing. Secondly if you declined all admissions for July as you should have or notifed me in July or even August that you are waiting for payment. This wouldn't have been an issue now. So I am willing to pay for July only so that you can reinstate and pay all the medical expenses that was pre-authorized by you in July 2020 and reversed, as you did not get payment.
Umvuzo Health Medical Scheme's replyOfficial
18 Feb 2021, 05:09Dear Petrus,
Thank you for your response. An escalations consultant will contact you during the course of the day for further discussion and see how this matter can be best resolved.
Kind regards,
Umvuzo Health
Thank you for your response. An escalations consultant will contact you during the course of the day for further discussion and see how this matter can be best resolved.
Kind regards,
Umvuzo Health
Umvuzo Health Medical Scheme's reply18 Feb 2021, 05:09
Official
Dear Petrus,
Thank you for your response. An escalations consultant will contact you during the course of the day for further discussion and see how this matter can be best resolved.
Kind regards,
Umvuzo Health
Thank you for your response. An escalations consultant will contact you during the course of the day for further discussion and see how this matter can be best resolved.
Kind regards,
Umvuzo Health
PV
Petrus V's updateReviewer Update
28 Sept 2021, 03:50A lady called me back. Came to a agreement that I may only pay for the month of July 2020 and they will pay all accounts that was reversed for that month. Said i will get confirmation email. Still waiting on the confermation email. So I can do the payment.
PV
Petrus V's update28 Sept 2021, 03:50
Reviewer Update
A lady called me back. Came to a agreement that I may only pay for the month of July 2020 and they will pay all accounts that was reversed for that month. Said i will get confirmation email. Still waiting on the confermation email. So I can do the payment.