Bonitas
No response and no one knows what they are doing

Hi

this has been going on for a long time. every month when i get my statement. a claims for the service date 17 may 2013 has been rejected. no one knows what to do with the claim. i have followed up with the doctor and the hospital and the claims is been re-submitted. the claim has been reject about 10 times already. reasons stated are "This is a duplicate claim line which has been previously processed." if that the case reject the duplicated lines and pay one line. other reason is "Claim details are either incomplete or incorrect. Please submit an amended claim" state what you want on the claim eg traffic code. i thought traffic code are standardlised. other reason is "Claim incorrectly coded by healthcare provider. Amended claim needed." state what is incorrect. cause the is a auth number on the claim. everything is correct.paper claim was sent i have called the call centre on the 16/08/2013 to get a clear understanding. query are open stating the claim processed. but guess what today i get my statement and the claim is still rejected. i thought the turn around time 48hours. 19 days later still nothing. guess what im not going to pay for this claim when it becomes STALE