10 claims processed for repayment to member - only 5processed however the amount refunded was incorrect.when we call for assistance nobody can assist-the totals they provide is what is due, however nobody can explain why the refund amount is incorrect.its ridiculous that's we have to gain pre. Authorisation numbers and answer many questions for every specialist visit and when its time for the medical aid to answer or provide what is due to the member then its okay to have loop holes in their system.we call and are limited to 3claim quesries and are asked to thereafter call back? How stupid is this? Why can the issue be resolved when we finally chat to someone? This is clearly a strategy to reduce processed refunds-once again only benefits the medical scheme.there systems are always slow-we wait up to 30min on each call sometimes or are told they will call back-this hasn't occu-we pay for a service, follow the correct procedures for authorisation&claims&still no answers! This medical aid is clearly one that clearly doesnt deliver when its affects their pockets. Pathetic that we are the ones wasting money and time on calls, emails back and forth since january 2013 without a positive resu
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