AO
Anel O

1 reviews | Active since Jan 2025

29 Jan 2025, 09:42

UMVUZO HEALTH NO COMMUNICATION, CLAIM QUERY

On 10/12/2024 we had a SPECIALIST appointment, I had to pay Cash and claim back from the medical Aid, I submitted all documents on the 11/12/2024 and made about 6 follow ups via email (REF: wf_*** - wf_*** - wf_*** - wf_*** - wf_*** - wf_*** - wf_***) with no feedback. I have called twice (call reference *** / ***) with empty promises or that they have a backlog. When i request a call back nobody calls, they say 10 - 14 working days its now 36 working days later. I see that they have now 28/01/2025 paid the claim but instead of paying me they paid it to the drs also not the full amount as they say claim is more than tariff amount. this is definitely the tariff for drs and not specialists. They are not capable of providing feedback and updates or following procedure, i submitted all required documents and proof of payment. Worst service and no feedback. Is it my responsibility to now call the dr for claim to be paid to me as they received payment from me and again from medical aid.

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Replies (2)
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply29 Jan 2025, 09:51
Official
Dear Anel Opperman

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 reply29 Jan 2025, 12:44
Official
Dear Anel Opperman 

Following the conversation with our consultant this morning, you were correctly informed that your refund will be processed during our next cheque run at Scheme rates. 

Regards
Umvuzo Health