Sitting with a bill

Item: Umvuzo Health Medical Scheme
Rating: 1
Author: Musa M

They authorised before the procedure but rejected the claims when it's time to pay.... The hospital is paid but the doctor and anaesthetist are not.

Why authorise if you won't pay?

Helpful (0)

Replies (2)

Umvuzo Health Medical Scheme's replyOfficial

16 Sept 2025, 18:54

Dear Musa

Thank you for bringing the unpaid claims to our attention. We’re sorry to hear about the inconvenience caused.

Our consultant will contact you to get details of the claims.

Regards
Umvuzo Health

Umvuzo Health Medical Scheme's reply16 Sept 2025, 18:54

Official

Umvuzo Health Medical Scheme's replyOfficial

17 Sept 2025, 09:06

Dear Musa,

We would like to confirm that you have already been contacted regarding the outcome of the recent claim review.

As previously communicated, the authorization letter dated 09 July 2025 at 15:15 indicates that tariff code 0667 is the only one approved at scheme rates. All other codes were declined, based on the clinical motivation provided for the admission on 10 July 2025.

During the review, it was noted that both the anaesthetist and the surgeon submitted claims using codes that were not approved.

Regards,
Umvuzo Health

Umvuzo Health Medical Scheme's reply17 Sept 2025, 09:06

Official

Dear Musa,

We would like to confirm that you have already been contacted regarding the outcome of the recent claim review.

During the review, it was noted that both the anaesthetist and the surgeon submitted claims using codes that were not approved.

Regards,
Umvuzo Health