AfricaComplaints.com » Health & Medicine » Complaint / review: Medshield - Claim not being paid reason unknown!!! | #95295

Medshield
Claim not being paid reason unknown!!!

On the 31/01//2013 my son was admitted to hospital where his paedatricain Dr Petrova ordered blood tests to be done. The majority of the account has since been rejected I have been trying for 3 months to find out why and sort this problem out. when I first phoned I was told that the claim was rejected due to the fact the medical aid did not receive the doctors request to have the test done after 2 months of the documents being sent by the lab to Medshield and them finally finding them on the 04/04/2013 they have been reprocessing the account. I phoned yesterday to check on the status of the claim and when it will be reprocessed as it is going on 3 weeks only to be told it has been reprocessed and has again been rejected this time because the codes are wrong. Firstly the claim has not been reprocessed as I have not received any notification via email the claim has been done nor does it reflect on my claims history on the online service. Secondly when i asked the agent dealing with the call if they can send me an email stating what the problem is with the codes so i can fix it i was told no i must wait till i get my statement so i can see. it seems to me they dont want to pay!

Date:

Company: Medshield

Country: South Africa   City: Accounts Department

Category: Health & Medicine

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