AfricaComplaints.com » Health & Medicine » Complaint / review: Resolution Health Medical Scheme - Non-payment of ICU/PMB and other claims | #29457

Resolution Health Medical Scheme
Non-payment of ICU/PMB and other claims

I gave birth to twins on 1 May 2012. They spent 3 months in Neonatal ICU. There is still a large unpaid Paediatric Bill, amounting to approxiamtely R285 000.00, which is currently 9 months in arrears. I have sent through motivation to Johan Mokgalaka, as to why Resolution are responsible for these costs. It seems as though the one twin was seen as a duplicate for the other twin. There are two children in question. Plus these are all PMB coded items, this was an ICU emergency and all costs need to be covered by Resolution. I spoke to Johan Mokgalaka on 3 Dec 2012, and emailed all unpaid accounts. He responded that he has referred for assistance. I contacted him again via email 31 January 2013 and again no response. I am really frustrated, as the Dr's are wanting to hand me over for legal action should this bill not be settled asap. I also sent him two other claims for myself which Resolution still have not resolved, one for R518.00 and the other R1090.00. I am furious. I want someone to contact me asap, other I have no choice but to contact Senior Management with regards, to this matter of the unpaid PMB's. Else I will contact the council of medical schemes for help.

Date:

Company: Resolution Health Medical Scheme

Country: South Africa   City: Customer Services

Category: Health & Medicine

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