Cape Medical Plan
REFUSAL TO PAY MODIFER 0019 CODE

I HAVE A BILL FROM THE PEDIATRICIAN WHO DELIVERED MY PREM BABY AT 35 WEEKS. HE WAS BORN 1 MAY 2012, 10 MONTHS AGO. HE CHARGED US WITH A MODIFER 0019 FEE OF NEARLY R8000. CAPE MEDICAL PLAN IS REFUSING TO PAY THIS AS THEY SAY HE IS NOT ENTITLED TO CHARGE ME THIS FEE.

I HAVE BEEN REASSURED THAT OTHER MEDICAL AIDS, SUCH AS DISCOVERY PAY THIS FEE NO PROBLEM. NOW THIS DOCTOR IS TAKING MY ACCOUNT TO LAWYERS BECAUSE THIS ACCOUNT IS 10 MONTHS OVER DUE.

I WONDER WHAT THE I AM PAYING OVER R1000 A MONTH OF MEDICAL PREMIUMS FOR IF I HAVE TO SIT WITH ISSUES LIKE THIS?

HOWCOME OTHER MEDICAL AIDS COVER BUT NOT CAPE MEDICAL PLAN . I AM AT MY LAST END WITH REGARDS TO THIS ISSUE. IT NEEDS TO BE SORTED OUT NOW.

Company: Cape Medical Plan
Country: South Africa
City: CAPE TOWN

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