PO Box 4346, Randburg, 2125
AS de Bruyn
I will try my best to complain in English. I am the caretaker of AS de Bruyn. She was in Eugene Hospital where she was treated with respect. She is a alzheimers pasient. On the 18 September she was well and was transfer to Medstep. The reason was to help her with physio to make her walk. With her alzheimers they let me in any time. Then I started to complain they must clean her. Every time when I was at her bedside she was smelly. I also comlain about other stuff. They give her something to sleep. On Friday the 20th September her grand daughter and I had a meeting with dr Deon du Toit, Carlien social workers, physio and a sister. They promise Lizl that they will stop sedate her. Saturday when I visit she was sedated again. I phone Lizl. Lizl phone them. They said it is to calm her down. She was so far gone and whit that they handcuff her. The 23 September I went to visit at 10h30 she was a sleep. I rang the bell for the reason she was lying with a dirty nappy. The suster came and ask what I want. I explain. Her answer was we clean this 2 pasient a few minutes ago. I walk out a male nurse with the name Justine ask me if I am okay. I respond no. Ask him went did they changed oumas nappy. He said just after breakfast. I believed him because of the smell I walk in. That afternoon when I want to visit the security gaurd stop me and told me I can not go in. On Wednesday the 25 I call a ambulans and arrange with Medstep that I am taking het to Eugene emergency. She was very sick. Emergency took photos she was so burned. Was admitted and at this moment she is laying in Icu.
All I whant to know what must we do to prevent it happenig to othet alzheimer pasient? And Medshield I am sure already pay the bill there.
Ns Sorry I am afrikaans and struggle to explain clearly
Settled fee with Service provider total up to a cost of R 767.30. Provider indicated that they treat at Medical Aid Scheme fees. Claim to be settled back to patient from Scheme equals up to R 361.00. Provide breakdown and documentation to support calculation of claim within Seven (7) days to avoid listing with Medical Instructions. Claim [protected] to be settle in full if Service Providers charge at Medical rates. Please supply rate scale to support evidence.
I have just had a look at the app an seen that my day to day benefits has been used which is untrue as I have...
We are members at medshield medical aid, option mediplus, member number [protected].
My wife ls pretorius had a spinal operation, performed by dr ja louw, on 14th of november 2017 at the life faerie glen hospital in pretoria.
Prior to the operation there were numerous tests that had to be performed, and pre-authorization was given for the said operation.
We received a very detailed letter before the operation, stating all the before and after care, as well as the notice that we are responsible for submitting the account to our medical aid, and to do regular follow-up calls to make sure it is paid.
In the notice from dr louw, appeared the following quote: according to the act on medical schemes, act 131 of 1998, article 59 (20) stipulates: "it is the scheme's obligation to pay a claim to the member within 30 days from receipt thereof". and I suppose it is also meant to be paid to the person that rendered the service, if so preferred.
The account was received by me on the 22nd of november via e-mail, and on the same day forwarded to medshield, and claim was acknowledged the same day.
From there on we phoned regularly, and first there appeared to be a problem with the authorization codes, and next time another story, and in the meanwhile most of the other accounts - faerie glen hospital, sunningdale hospital (step-down) and just about all the parties involved in supplying service to the operation, was paid about 4 to 5 days after accounts were submitted.
On the 22nd of december 2017 we again spoke to an supervisor, keenan johnson, and I told him that I feel very bad because it is now 30 days after account was submitted, and still unpaid, and I am going to pay the account, because I signed the contract with the dr. he said they are working on the case, and so I was told every 3 or 4 days.
The query number was 221217qjt86l, and is still not resolved. all e-mails sent and calls made concerning this problem is stored and recorded under this number.
On the 23rd of december we received a general note form medshield, stating they have a system problem and some account payments will be delayed. the note was dated 16th of november 2017 - we received it on the 23rd of december?
Delay in the processing of some claims
Medshield recently upgraded its claims processing system as part of its commitment to remain on the competing edge of technology. once upgraded, the system will enable automated processing that previously required manual intervention. this will result in quicker claims payment turn-around, therefore ensuring that you continue to enjoy the extraordinary customer service that you have become accustomed to.
Claims were placed on hold on thursday, 16 november 2017, and implementation proceeded as expected. the scheme continued with the processing of claims but due to a technical glitch we encountered some processing difficulties which lead to the incorrect payment of claims. subsequently claims could not be paid and will remain as such until the issues are resolved.
Medshield is cognisant of the impact the current situation will have on some of your claims and we have allocated additional resources to the project to ensure a speedy resolution.
We sincerely apologise for any inconvenience experienced and appreciate your patience while we resolve the situation and finalise the system upgrade.
All queries relating to this communication may be discussed with an agent on [protected] or email to [protected]@medshield.co.za.
Ms angela blackburn
Executive: operations | medshield medical scheme
On or about the 4th of january 2017 I withdrew money form my savings, and paved the account (r23 702.32), after arrangements was made with the dr.'s office to refund me when they receive payment from medshield.
On the 15th (yesterday) I spoke with as "section manager"??, a mr modire, at medshield, and he promised (one again) he would get back to me before 17:00 - which he did not do!! (once again). I did advise him that I am going to hellopeter.com today.
All the calls are on tape at medshield, and the given query number would give all information.
I must admit that this is the first time in many years that we have a problem like this, and in general we are quite happy with medshield, but, in a case like this, whenever a problem like this occur, I would like to see e more senior person should be getting involved, and at least contact the member, and explain there problem. the I can forward it to the dr.'s office, so at least they can get first hand information directly, and not from the member.
As member, my subs are deducted every month via debit order, what more can I do? no one is going to re-imburse me for all the time that i/we have spent on the phone trying to solve the problem, nor for the costs of the phone calls, nor for the interest I loose on the savings I used to pay the dr.'s account.
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I am up in arms with Medshield! For 3 weeks I've been calling them to find out about a payment for a claim that I submitted to them. For 3 weeks they've told me that the claim in in process and that it will be paid out on the Thursday. Thursday came and gone and a promise were made for the next Thursday. I called yesterday with the hope that it might be this Thursday and got told that they will not pay me out and in fact the entire bill will not be paid. Why couldn't they tell me this 3 weeks ago! I just want to cancel my Medshield medical aid and move on and they refuse to cancel my medical aid! They cannot force me as a consumer to stay with them. I feel that their service is very bad from the beginning and that I can't allow Medshield to gamble with my life! If I need to get legal advise on this I will, I just want to leave them and go to someone else!
They take your money but just try and get an authorisation for something. We've recently moved to Medshield and they took us on with no exclusions or waiting periods but aside from that we did inform them of the tumor-like growth in my brain. After seeing the neurosurgeon about 2 weeks ago he said that I should go for another MRI. That's where the trouble started. We've booked with a hospital after which they (the hospital) contacted us to say that it's not authorised by Medshield. We contacted Medshield and they said it takes a week for auth which I thought is a bit long given the seriousness of the case. Gave them a week and phoned again after which they said that they are waiting for a report from our house doctor. Asked if they have the house doctor's details and they said no. So, how can you wait for the report if you haven't even contacted the doctor! Gave them the house doctor details a week ago, guess what, we're still waiting for Dumisile to get back to us with an auth after two weeks. They are quick to take your money but you must follow up with them each and every day if you want something from them.
You'll do good to look somewhere else for a medical scheme.
I needed to switch my husband to the main member as I had changed companies and was required to leave my current medical aid if I was the main member. I did not want to leave Medshield, so we decided to simply switch the main member. BIG MISTAKE!
It took many phone calls and emails to medshield before I got the correct information from Medshield around the process for switching the member and the dependant and when we finally had everything in place I called to confirm that the current benefits would be transferred and not forfeited. I was guaranteed that this was the case as it was simply a member switch and not a whole new application. I phoned today to be told that it is a medical scheme rule that benefits get forfeited when a member switch is done. I now have been told to write a letter to the Medshield management to request they review my case, probably another waste of time. They are quick to offer advice as experts, but don't have the authority to act on issues caused by their advice. R15000 for 2 doctors visits and a handful of medication! And the funny thing is I am still the one paying them!
I decided to join as dependant on my fiance's scheme after she received excellent service from you for the past 8 months. But whats happening now? I only joined medshield this month (20th) and ALREADY having problems. You deducted R1911 instead of R1308. When I send my application through, I asked on 2 occasions to 2 different people what the first an total monthly contribution will be and was told R1308 for the both of us. Today I spoke to Carmen who was very kind and helpfull and was told that it must be a mistake and said she will put a req in for the amount of R603 to be reversed. I really hope to see that amount to be reversed a.s.a.p. Let's hope this was the first and last problem.