On 17 Dec 2013, I went to the gynecologist for my 8 week pregnancy check up. I was told that the baby's heart stopped beating and that I would require an emergency D&C the following day. I phoned Resolution with all of the cost & charge codes to get authorization for the procedure the next day. As this was a D&C, anesthetics was needed. In January 2014 I received the statement form the Anesthesiologist which I submitted for payment to Resolution. This was an emergency and such qualifies as a PMB which all medical aids are obliged to pay in full regardless of the health plan. Only about a 3rd of the account was paid to the Anesthesiologist which leaves us to pay the rest. When I phoned the claims department today to find out why this has happened, the call centre agent was extremely rude to me and I was transferred 3 times with no resolve.
I am still struggling emotionally to cope with the loss of my baby and now I have to deal with accounts not being paid and rude call centre agents. If this isn't resolved, I will have no choice but to report Resolution to the Council of Medical Schemes.
Please can I get some assistance in getting the matter resolved?
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