I had my second Hip operation performed on the 3 June 2013, before then i contacted the Medical scheme, and they authorised the claim and there was no problems with the codes... Mid July i received a red letter from the Surgeon claiming that the medical aid has not paid, once i was back on my feet, my nightmare begun, call one, you query has been escalated, you will hear from us in 5 days time, okay call back, still no progress or feedback, all they can say is your query has been escalated, but no-one is assigned to attend to your fault, for every week thereafter, after numerous calls, i get told the same thing, this is now week 4, i have asked to speak to a manager several times, none of them or the supervisors are available, one consultant said that the Surgeon charges out of scheme rates, the Hospital, the Physician, the Anaesthetist, the Physiotherapist, all CHARGE out of scheme rates but the medical paid them all but not the most important person whom perform the Operation which was the surgeon... what makes matters worse is that the medical aid paid full for the same operation last year April
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