1 reviews | Active since Mar 2009
UNAUTHORISED PROCEDURE
We are on the Standard plan with Umvuzo. My husband had a malignant melanoma which we got authorisation for from Umvuzo for the specialist to remove. He was admitted and the lesion was removed, He then went for his follow up visit with the same surgeon on the operation site that he operated on, For the follow up visit of R640.00 we were declined payment, the reason being - UNAUTHORISED PROCEDURE. What they actually wanted me to do, was go back to my GP, get another referral letter to go back to the surgeon for the follow up visit. Beyond STUPID!!!!!!!!!!! This is Umvuzo Healths favourite term on the standard medical aid scheme, I probably pay out of pocket more money than they actually take from me in some months, I am now forced to go up to the next option as they may then pay for certain procedures. If I still have no luck on the next option it will def be time to look for a new medical aid. VERY POOR SERVICE from them.
we can understand your frustration with having to obtain authorisation once again for the follow up visit at the specialist. This is how the Standard option is structured, that members have unlimited access to GP's on the Universal network. This is the reason every specialist visit has to be referred by him and pre-authorised. This is by no means a way to deny access to the secondary care, but is a coordinated way to ensure only clinically indicated cases are referred to secondary care providers.
You will find that by adhering to the Scheme rules, the Standard option does offer great value for money and has more than adequate benefits. It is also understandable that network options do not suit everyone, and some members opt for a freedom of choice option that provides a lot less restrictions.
Our next option after the Standard Option is the Supreme Option, which is a freedom of choice option, where your day to day benefits, which include specialists and GP's will come out of your Family benefit.
To conclude this matter, one of our consultants will be in touch with you, to ensure all your questions are answered and offer resolution of any outstanding mater.
Kind regards,
Umvuzo Health
we can understand your frustration with having to obtain authorisation once again for the follow up visit at the specialist. This is how the Standard option is structured, that members have unlimited access to GP's on the Universal network. This is the reason every specialist visit has to be referred by him and pre-authorised. This is by no means a way to deny access to the secondary care, but is a coordinated way to ensure only clinically indicated cases are referred to secondary care providers.
You will find that by adhering to the Scheme rules, the Standard option does offer great value for money and has more than adequate benefits. It is also understandable that network options do not suit everyone, and some members opt for a freedom of choice option that provides a lot less restrictions.
Our next option after the Standard Option is the Supreme Option, which is a freedom of choice option, where your day to day benefits, which include specialists and GP's will come out of your Family benefit.
To conclude this matter, one of our consultants will be in touch with you, to ensure all your questions are answered and offer resolution of any outstanding mater.
Kind regards,
Umvuzo Health