Resolution Health Medical Scheme
HORRIBLE REMITTANCE ADVICES TO SERVICE PROVIDERS

I complained about the way Resolution structure there remittance advices to the Hospitals indicating payment for the patients. The payments of various episodes (hospital visits) are mixed on and this result in incorrect calulations. Co-payments are added under the incorrect payment heading indicating members to be paying more that what they actually needed to do. When this is reversed, they actually do not fix the payment, they deducted the amount twice. I have tried various ways to speak to a person at the responsible department and was refused, each and every time. I believe somebody working in this department is either clueless or just don't care enought to make sure that the payment advice is properly constructed to indicate member liability, provider payment and a seperate coloum for rejections, and not the mixup we are getting. Rejections also have NO REASONs, the payments are just indicated as not being made, period. Now the hospital telling the patient to paid these amounts is getting a bad review, while in actual fact, it is Resolution that need to start sorting out their inhouse mess. I hope I can get a decent answer to this, and a proper contact nr.

Company: Resolution Health Medical Scheme
Country: South Africa
City: Mpumalanga

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