In 2012 I got written permission from Medshield to have my baby at a non dsp, they also waivered the 25% co-payment. I got my auth number early in January, it was confirmed in an e-mail with the words "without penalty".
Now, after the birth of my baby (in Jan already) I am sitting with an unpaid hospital account. I made various calls and sent e-mails. Eventually I was contacted by Thorn Haxham from MSO who assured me that the account would be sorted out.
Eventually I received an e-mail from MSO saying that the hospital has overcharged on some of the codes (58012/58013/58011). I have been e-mailing mr Haxham but no response to date.
I can not accept the answer I got from Medshield. My baby was born premature, making my case a PMB, therefore Medshield should settle the full outstanding account. Secondly, I sent my hospital account to a Mediclinic that is part of Medshield's network to compare the amounts charged on the codes in question. It seems the difference is less than R700.00.
If I calculate what the 25% co-payment would have been on my hospital account and the amount that the hospital "over-charged" according to Medshield, there is not a very big difference.
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