Topmed Medical Scheme Complaint
 SUPPLIER |
Topmed Medical Scheme |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | headoffice | COUNTRY | South Africa |
| TIME / DATE | 07:28 Mon 12 Dec | PERSON RESPONSIBLE | |
| CUSTOMER | michele77 | View all reports by user |
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| PROBLEM | Billing / Accounts |
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| INCIDENT | Sat 10 Dec | ||
| HEADLINE | Bad service |
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i have been trying sins sept to get feedback about and account that was send to the medical aid sept last year. i requested an account from the dentist, but they told me that they will send it straight to the medical aid. been calling and following up sins sept, and it was confirmed that the account was sent t to medical aid, but declined becauses the independant code is incorrect. confirmed with the medical aid that they check the dependant code and the date of birth (that is correct on the account), they also confirmed that the with the date that is correct, they should not have declined it. i also called the medical aid and asked them why would they put me on dependent code 2 if i am the only one on the medical aid and paying it ? they said that is how it is done. So why should i be penalised for them insisting to put me on dependant code 2 and then declined because the dentist put it on 1 with all the other detials being correct. I am really dissapointed. been paying for years, and now being persued by collecting company ? Please get this sorted. |
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| SUPPLIER'S RESPONSE | Topmed Medical Scheme | Time and Date | 08:43:37 | Mon 12 Dec 11 |
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Hello michele77, Thank you for bringing this to our attention. Kindly note that we are currently looking into your query and will provide you with feedback shortly. Kind regards Priscilla Moodley |
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| UPDATED RESPONSE | Topmed Medical Scheme | Time and Date | 10:16:08 | Mon 19 Dec 11 |
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Hello michele77, Further to our telephone conversation, I wish to inform you that a dental claim by Dr Farao and Assoc, for 2010, was not received by Topmed Medical Scheme, as the dental claims for 2010, were processed by Dental Risk Company. I have called DRC and they confirmed on reference number 2011121914100012, that it was not received by them. Please note that your dependant code is correct, even though you are the main and only member on this contract, the code is 02. If a claim is rejected ,for any reason, it will still reflect on our system and show the rejection reason. In this case, the claim is not on the system. Kindly forward me the lawyer`s letter sent to you, on an instruction from the dentist, for further investigation. Kind regards Lindiwe Mpanza (Ms) |
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