Medihelp
Inconsistent information from call centre agents

14/08/2013: I called Medihelp to find out what the procedure is if one of my dependents were to visit an out-of-network GP - I spoke to Charles who said no auth is necessary and I should just submit the account afterwards.
28/08/2013: After my husband visited the out-of-nework GP I phoned Medihelp to find out how to submit the claim, I spoke to Kyle who said that I needed an auth number!!! When I gave him the details of my call with Charles, he said that I should just submit the claim and wait to see if it's approved or not.
I e-mailed the claim on the 28th.
13/09/2013: I receive a statement saying that the claim was rejected because there was an omitted item code - I then called and spoke to Martha Kgoagi who was most UNHELPFUL, she said the claim is new and she can't view it - hello, I submitted it 2 weeks ago how could this be a new claim?
I have two problems here: firstly the PATIENT on the statement was captured as myself, where on the Account it clearly states my husband's name! Secondly, why could you not just pick up the phone and call the doctor concerned to get the code? I suppose because it's easier to just decline claims and hope the member won't take it any furthe

Company: Medihelp
Country: South Africa
City: Call centre

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