RM
RONNIE M
Active since Feb 2019
4
Reviews
0
Industries
Reviews
4 reviews33 months ago
UNPAID PHYSICIAN ACCOUNT BONITAS BONCAP
I am so fed up So my Physician Dr Mngaza Practice number 0624357 assisted a patient in Hospital in January 2023 from 01/01/2023 up to 06/01/2023 and this account is still not paid!!?? We have been phoning Medscheme and the now adminastrater PHA several times Medscheme can not help as they do not administrate BONCAP any more and PHA can not help as this account was before they took over BONCAP We have all these ref numbers for patient Mrs Steyns account under medical aid number 4700287002 and seven months later still no Feedback on payment for this account REF NR 300123QHJHKF FOR 30/01/2023 REF NR 060323QK2Z31 FOR 06/03/2023 REF NR 130423QLMS4Y FOR 13/04/2023 REF NR 110523QMSP95 FOR 11/05/2023 REF NR 641589999 FOR 21/06/2023 REF NR 210623QPHVMH FOR 21/06/2023 REF NR 100723QR7HGZ FOR 10/07/2023 REF NR 240723QRWRZ0 FOR 24/07/2023 And then on the 04/08/2023 I phone again and now I need to send a paper claim if I want this account to be processed so do you think this a how a medical aid should operate. All you People on Bonitas Boncap resign and go to DISCOVERY KAYCARE at least your accounts will get paid. And then do not let me get started on Remittance advice's it is non existing if it comes to BONCAP you can request till you are blue in the face and there is now web side were you can register on to get them your self!!!!!
60 replies
34 months ago
Discovery Health SAB medical scheme and Sizwe Hosmed
So where will i start I have an account for an Anesthetist for 06/12/2022 there was a valid Auth for the procedure done. according to Richard from Discovery the claim was short paid as it did not link to the auth ( 27848666) but they are no longer administrating SAB medical scheme so i have to call 360 health spoke to Nduvho that advised me that they are not working on 2022 claims at all so now i have an account for my Anesthetist that is not getting paid as no one is taking responsibility for any 2022 Sab medical scheme claims any more so where do i go with this unpaid claim back to the member?
0 replies
34 months ago
Platinum health Unpaid for 8 months
This medical aid can not pay an account that was submitted on the 11/11/2022 for 8 months we have followed up on this account emailed proof of submission gave all our ref numbers and today I phone and still this account is not on Platinum health system and they do not have a turn around time of how long this will take as per Verginia the agent that assisted me today and argued with me that we are at fold as this is a stale claim that was not submitted in time no matter how much i tried to explain to her that it is not that we have send proof of submission and i can give her all my ref numbers she still tells me we did not submit this in time and a ref number is just my record that this was queried so now My Anesthetist is not getting paid and the patient will not be able to submit any short fall of this account to his GAP cover if he has one, and i wonder if the medical aid is going to man up and explain to him why he is going to have to pay a short fall for an account that is 8 months old all ready, And as per Martha Van Wyk the second agent I spoke to today and to whom i emailed the claim with proof of submission directly on the 09/06/2023 we have to wait as she can not tell me how long this will still take
0 replies
38 months ago
Complaint
Unpaid account for Dr A. De Beer practice number 1008366 ADB1088 Member Late Mrs H. Bauskin member number 156132010 service date 08/07/2022 . The patient passed away 10/07/2022 La Health made a payment of R5793.40 into the patients bank account which then was written back to the medical aid as Mrs Bauskins bank account was dormant from 2021. We have now been struggling to get Doctors account paid from 2022 they keep telling us we must send them details for the estate (She didn’t have an estate, lived in the Sandringham Gardens Home for the Aged and only had a small pension which was paid directly to the home. There is no estate to claim from - she had no assets at all.) This is from the Next of Kin, and they phoned Discovery from their side as well. My question now is why does the Doctor now have to have the inconvenience of not getting paid for a service that he has rendered 8 months ago as the medical aid clearly does not understand that they cannot pay the deceased Member or an estate that does not Exist??
106 replies
Review Distribution
5 Star
0 (0%)
4 Star
0 (0%)
3 Star
0 (0%)
2 Star
0 (0%)
1 Star
4 (100%)