I feel betrayed!! I pay thousands of South African Rands to belong to a medical aid scheme per month to ensure peace of mind for my family and me to receive private health care when the need arises. My husband was admitted to Entabeni Hospital on the evening 05th July by the trauma doctor on duty.
He stayed until the afternoon of the 7th - during his stay the attending doctor assigned to treat him in-hospital had requested the services of a clinical medical professional to treat my husband. The nightmare began a week later when the medical aid rejected the hospital claim stating that the authorisation numbers obtained were inadequte to cover part of the hospital claim of R9336.00. Aparently the clinical medical professional was not a doctor!! But they did indeed pay his claim fees of R1592.00 for one hospital visit. Due to some sort of administrative error I have now received demand letters from Entabeni Hospital to fit the bill of R9336.00. Why am I responsible? Was I supposed to know during the time of duress that there needs to be 2 authorisation codes or claim codes for a payment to be effected by the medical aid which i pay loyally for services? To date nobody has heard me.
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