Medihelp
Short-payment on PMB conditions

I have a hospital admission auth no:201211200183 for Brenthurst hospital, dated from 19.11.2012-28.11.2012, and this was a PMB Condition admission, I have several received Pathology accounts, Mauff and Partnes (52 pr) which were short paid, and what annoys me is that, Medihelp is now paying this so called "exceeded tariffs from my 2013 MSA, Secondly I have received a statement dated 30.01.2013, no 88 with claim process number-00266338647 whic Dr MP Mojapelo, a GP who is practicing as an Anaesthetist at Brenthurst with PMB ICD 10 Codes: K27.1/K92.2, dated 26.11.2012, and the amount of R2032.52 has been paid from my 2013 Savings Account, on speaking to Gerrie on 05.02.2013 with Ref no-T9071760, confirming that the account was partly paid from my MSA as the services were not registered on the PMB List, however I reminded him of the mandate letter dated 2012, June by Medihelp to its members, "please be advised that effective 01 August 2012, there will no longer be co-payment applicable on hospital admission, co-payment will apply from the 14th admission, 2nd: All admissions with PMB conditions will be automatically be registered by Medihelp, I escalated this to CMS, the Registrar.

Company: Medihelp
Country: South Africa
City: Arcadia

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