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Question

10 Jul 2005

Stale Account
My late husband died 4 years ago in a motorcycle accident, and in June this year I get an account from WP Blood Transfusion Services which they had faxed to my Med; aid for a rather substantial amount. The address under my late husbands name was an unknown P.O. Box in Johannesburg, and neither my Medial Aid or myself have ever seen an invoice, nor been contacted by WPBTS before. What are my rights?
Peggy
Answer 558 views
Expert
Medical schemes

01 Jan 0001

A service provider have to submit a claim within 4 months from the date of service before it becomes stale. After 4 months the claim will be rejected as stale. I suggest you liasse with the WPBTS to make sure whether they have submit the claim within the 4 months and get the proof from them.

The problem is that you as the member remains liable for all claims. The service provider does not have a contract with the scheme, it is the member. It is expected of the member to make sure that all claims are submitted to the medical scheme.

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