Medihelp — after waiting period claim not approved
Date: April 2018
Contact details: [protected]
Medihelp Nu: 5929598
We have enquired to get a pair of glasses for our daughter, Anschia Pauw, who is a dependant on our Medical Aid. She was on our medical aid up until end of 2016 when she returned from the states we added her back onto the medical aid. Medihelp advised that she is a new member and needed to wait for a three month period before she can claim. Long after the waiting period We had her eyes examined, after which PPN could not put it through on their system as they say that Medihelp has not loaded her as a new client.
I then called Medihelp and spoke to Chantelle, who got back to me, saying that PPN only allows a claim within a 24 month period. The optometrist has spoken to PPN and they advised differently. They advised the following: "said that if Medihelp confirms that she is a"new"member, then they are able to change their system, however Medihelp needs to inform them accordingly. As far as I understood the consultant said that they will change their system as they need to go with Medihelp's rules, so if Medihelp sees my daughter as a new member on their system, then they need to do it the same for optical."
I am highly upset that this matter is dealt with in this way as my contact with Medihelp states a three month waiting period and according to PPN you needed to update your system. Medihelp gives contradictive answers to a claim. I would like Medihelp to do what they say in their terms and conditions and allow us to get a pair of glasses.
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