Topmed Medical Scheme Conversion
 SUPPLIER |
Topmed Medical Scheme |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | Bellville | COUNTRY | South Africa |
| TIME / DATE | 15:02 Wed 11 Jan | PERSON RESPONSIBLE | |
| CUSTOMER | dck | View all reports by user |
 1
 1
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| PROBLEM | unpaid dental claim |
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| INCIDENT | Tue 30 Aug | ||
| HEADLINE | unpaid dental claim |
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Member No: 3542547 Service Prov: Dr P J Botha (Practice no 9200614) Patient: Hester Service date: 2011/08/30 Tariff Code: 8234 Amount: R504.00 Reason for non-payment "Tariff code incorrect or omitted. " Dr confirmed tarif code is correct. After many calls (see below), Shaun said reason actually is that Hester received a dental plate in the past 24 months. I told him this is the first time ever in her life she received a dental plate. He referred the claim back to his dental department - that was beginning of Dec 2011. 9/1/2012 I call again when Gerath said he will refer it back to his dental department. As you will see from all the calls below, Topmed keep on referring it back to their dental department and promise to call back, which never happens. Telephone calls: On 20/9/2011 with Chanelle ref 134662686 On 29/9/2011 with Chanelle ref 135267172 On 13/10/2011 with Cindy ref 136161716 On 10/11/2011with Chanelle ref 137958040 On 21/11/2011 with Chanelle ref 138685049 On 22/11/2011 with Lindiwe ref 13874275 On 23/11/2011 with Chanelle ref 138827935 On 8/12/2011 with Shaun ref 139918928 On 12/12/2011 with Shaun ref ( not given) On 9/1/2012 with Gerath ref 141846446 |
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| SUPPLIER'S RESPONSE | Topmed Medical Scheme | Time and Date | 15:15:11 | Wed 11 Jan 12 |
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Hello dck, Kindly note we are currently investigating your query and will get back to you shortly. Kind Regards Priscilla Moodley |
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| UPDATED RESPONSE | Topmed Medical Scheme | Time and Date | 16:07:49 | Thu 12 Jan 12 |
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Hello dck, Further to my previous email, it has been noted that Shaun Baatjies has contacted you and he will inform you once a decision is reached. Kind Regards Priscilla Moodley |
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| CUSTOMER'S FEEDBACK | dck | Time and Date | 18:43:53 | Thu 12 Jan 12 |
| Quite Impressed: Shaun called twice and informed me that they will process the claim again. He will let me know of the outcome. | |||
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