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Doctor sues PSMAS over $208 000 in unsettled claims

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A MASVINGO-BASED medical doctor, Erasmus Hlatshwayo, had taken the Premier Service Medical Aid Society (PSMAS) to court, seeking to recover $208 000 he is owed for services rendered for the period ending June 19 this year.

A MASVINGO-BASED medical doctor, Erasmus Hlatshwayo, had taken the Premier Service Medical Aid Society (PSMAS) to court, seeking to recover $208 000 he is owed for services rendered for the period ending June 19 this year.

BY CHARLES LAITON

Hlatshwayo filed his summons against PSMAS on July 12 this year through his lawyers, Mundia and Mudhara Legal Practitioners.

In his declaration, Hlatshwayo said sometime last year, he signed a deal to provide services to the firms’ members on condition PSMAS would pay for the claims within 60 days of receipt.

“In terms of the agreement it was agreed amongst others that; plaintiff (Hlatshwayo) would provide medical services to all defendant’s (PSMAS) medical aid scheme members who hold a valid medical aid account. After treatment of the members, plaintiff would remit the claim forms to the defendant for payment and defendant would pay all the plaintiff’s accepted claims within sixty days of the claim being lodged,” Hlatshwayo said in his declaration.

“Plaintiff at various times during the period ending June 19, 2017 provided medical services to defendant’s members and submitted claims in the sum of $208 483 for payment by defendant which claims were duly accepted and approved by the defendant.”

Hlatshwayo said PSMAS breached the agreement by failing to pay for the submitted claims within the agreed 60-day period, prompting him to approach the court for recourse.

“As at June 19, 2017 defendant owed plaintiff the sum of $208 483 in unpaid claims and despite demand, defendant has failed, neglected and or refused to pay the said sum,” The health insurer is yet to respond to the litigation.