OJ
Olivia J

1 reviews | Active since Jun 2019

17 Oct 2024, 17:57

No authorisation Response May be Life Risking

As a specialist healthcare provider I am dismayed by the service my patients are receiving from this scheme. My patient has had multiple life threatening events that can be prevented by a hysterectomy. She has been admitted twice with life threateningly low haemoglobin levels requiring blood transfusion. She may possibly progress to cancer as this pre-malignant. I have been asked to send Pap smears and motivation forms on more than one occasion and have received no feedback.

One spends two hours on average trying to not listen to music. We would much rather speak to consultants to find a solution that would save this patient's life.

We have not received a single response with an authorisation code or even rejection in order to know how best to next help this patient. Her livelihood and pay is being compromised as she can't work when she loses so much blood and becomes weak.

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Replies (4)
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply17 Oct 2024, 21:31
Official
Dear Olivia J
 
We acknowledge receipt of your complaint and apologise for your negative service experience.
 
Our Service Consultant will contact you shortly to get more details of your query.
 
Regards
Umvuzo Health

Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply21 Oct 2024, 09:44
Official
Dear Olivia J

As discussed with our consultant, please send outstanding physician and pathology report to complete the case

Regards
Umvuzo Health
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply28 Oct 2024, 09:38
Official
Dear Olivia J

We tried to reach you to discuss the case further but couldn’t get through. Our Medical Advisor has approved the procedure, and one of our clinical consultants will call you back at your convenience. 

Regards
Umvuzo Health
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply28 Oct 2024, 15:35
Official
Dear Olivia J

Following your discussion with our clinical consultant, it was noted that you were unable to continue with the call, and suggested that she provide the information to your practice instead. 
She has since reached out to the practice and confirmed that the procedure scheduled for November 6th has been approved.

Thank you for your patience in this matter.

Regards
Umvuzo Health