As per medical aid rules, 12 specialist visits are allowed per member per year. I obtained pre-authorisation for a specialist consultation and took the precaution of having the scheme email me the pre-authorisation number, as I have had problems with them not paying in the past. On the date of service I e-mialed the claim which I had paid for in cash to the claims e-mail address and receved confirmation of it being received. I was not paid and followed up on the 30.10.13 and was told my claim was never received. I was asked to re-submit to the consultants direct email (amsomi), which I did and she confirmed receipt, yet nothing was done. I followed up on the claim again on the 17.10.13, a month after the service date, and was informed by Kutlwano that my claim was never received. I am very frustrated with the utter lack of service continually received from every employee of this scheme and i have to complain on hello peter each time just to get a rsponse from them.
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