Pathcare
Unable to process one claim to two medical aids

Health & Medicine

My son was admitted to hospital two days before I was due to change medical aids. I was approved for both and had unlimited hospital cover on both medical aids. The fact that from date A to date B medical aid 1 would be responsible and after date B medical aid 2 would be responsible to cover the costs. This proved a problem with the hospital and doctors, but it was resolved quickly without too many problems or correspondence.
The problem is that Pathcare is unable to understand and process the claim within the parameters. The account dates back from August 2012 and still it is a problem and again this account was handed over to debtors control.
The fact is that I have phoned and emailed numerous times trying to get them to understand the situation. Every time they come back with the response that the claim was rejected because it falls outside the cover date. But they keep on claiming from my old medical aid. In 2012 I sent a detailed mail with the dates and membership numbers for them to be able to process the claim correctly, but that same mail is still not being read properly up to today.
Promised calls from management also never happens.


Company: Pathcare
Country: South Africa
City: Accounts
  <     >  

RELATED COMPLAINTS

Thebe Medical Aid Scheme
CLAIM REFUSED TO BE PAID

Medihelp
Worst service of all medical aids

Discovery Health
Hugely expensive Medical Aid, very poor cove

Ampath
Want to list me on ITC

Momentum Health
MEDICAL AID

Old Mutual
Excuses and more excuses!

Fedhealth Medical Scheme
Unpaid medical claim AGAIN

Ombudsman Medical Aid
Medical Aids adding late penalty fees

Pathcare
Bad Service - Fixing Billing Mistakes

Bonitas
Bonitas - Best Value for money