Resolution Health Medical Scheme
Time to get your house in order

My mother had an op in Nov '12, I had 1 in Dec '12. I am still struggling to get Resolution to pay/correct certain accounts. Started with mom's hospital bill not being pd - wasn't authorised, it was & had to be corrected. The surgeon's bill not pd as it wasn't authorised, captured under the wrong date, took them awhile to acknowledge THEIR mistake. Further queries with regards to this acc, I was told no paper claim - they had it, I have a copy sent from THEIR customer services. Now reason for short payment is Drs bill excessive. Everytime I query certain things I get a different reason why its not pd eg tarriff code wrong - proved code was right, now get told "its excluded" but if auth updated sooner they might have pd, I queried as soon as I got their statement!!! Had MRI day earlier than auth date - wasn't pd, not authorised. Mom's inhospital radiology bill not pd in full, queried in Jan '13, was told pd from day2day, should be inhospital. 2day get told wasn't preauthorised & so it goes on. Both our anethetists short pd, they need paper claims, prev submitted & so it goes on. To say I am not happy is a major understatement & don't know what 2 believe anymore.

Company: Resolution Health Medical Scheme
Country: South Africa
City: Customer Service

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