During the peiriod of 01 Feb 2007 and 28 Feb 2013 i was a registered member of GEMS Medical Aid. Thato Nduna was a dependant on my medical aid. On the 10 Feb 2011 and 15 Feb 2011, Thato my depanded consulted Dr E A Moosa - Practice number 3202291 consulted Dr Moosa. During that time, I was still registered as a member on the medical aid. Aneesa from Medistat Outsourcing Services claims that she sumitted the claim to Med Aid. But when I contact the Med Aid, they only received the claim on the 16 Sep 2011 and it was registered on the system on the 19 Sep 2011. That was more that 6 months after Thato has seen Dr Moosa. According to Med rules, all Dr's have only 4 months to submit their claims to Med Aid. I only realised now in 2013 that the claim was not paid. When contacted the Med Aid, they explained to me that the Medistat, that is dealing with accounts, submited the claim late hense it was not paid because it fall under STALE CLAIMS. Aneesa insists now in 2013 that she was sending statements to my home address of which i don't trust her. I asked for proof, which I am still waiting for until now. Why must i be held responsible for the FAULT? It's really not fair on my side
0 comments