3 MONTHS TO REPROCESS CLAIMS!!!!!!!

<p>This is my 2nd complaint on Hello Peter for the same enquiry.</p> <p>3 months down the line and only 2 or 3 claims of the 14 or 15 from January 2016 have been reversed and reprocessed from PMB and put back into savings ....36 physio treatments have been approved for Mrs L Steinbach as per correspondence below to be paid from PMB due to cancer of the spine which has left paralysis from the chest down.......yet these claims are still not paid.....I have authorisation to speak on my mothers behalf she is 80 years old and lives in Frail Care she is NOT getting her physio because Bankmed does not pay her PMB claims as PROMISED.........I have dealt with Chelsea initially, the Esther, then Monday I phoned and spoke to Aalia who also PROMISED me feedback still nothing.</p> <p>Please can someone at Bankmed tell me what to do to get all the claims for N DUFF (PHYSIO) reprocessed from PMB and put back into her savings.</p> <p>This is my last attempt at trying to sort this out myself, if ALL THE CLAIMS FOR N DUFF ARE NOT REPROCESSED AND PAID FROM PMB BY THE END OF THE WEEK I AM LODGING A FORMAL COMPLAINT WITH COUNCIL FOR MEDICAL SCHEMES.</p> <p> </p> <p>13 January 2016</p> <p>Membership number: ********** 60 <br /> <br /> Dear Mrs Steinbach <br /> <br /> Thank you for your recent contact with Bankmed Medical Scheme.</p> <p>Application for Out of Hospital Prescribed Minimum Benefit</p> <p>We have received an Application for Out of Hospital Prescribed Minimum Benefit for Mrs Loretta Steinbach the Discovery Health PMB email address for this Bankmed member. Mrs Loretta Steinbach is registered on the Bankmed Plus Plan, and does not require that a OHPMB Application form be completed in order for the claims to be funded as such.</p> <p>PMB related claims will automatically fund from the Prescribed Minimum Benefit for this plan type in full if you are a designated service provider (DSP) for Bankmed or at 100% Bankmed Scheme Rate if you are a non-DSP.</p> <p>Plans that do not require OH PMB Application Forms</p> <p>The following Bankmed Plans do not require an OH PMB application form to be completed: Bankmed Plus Plan, Bankmed Comprehensive Plan, Bankmed Traditional Plan and the Bankmed Core Saver Plan. Claims relating to PMB treatment automatically funds from the Scheme and medication is funded through Medikredit.</p> <p>Plans that do require OH PMB Application Forms</p> <p>The Bankmed Basic Plan and the Bankmed PMB Plan does require that an OHPMB Application Form be completed and emailed to ********** for review.</p> <p>If you have any more questions, please call us on 0800 Bankmed (0 ********** ) or email ********** <p> </p> <p>Yours in good health<br /> Prudence Nephawe <br /> Bankmed Medical Scheme</p> <p> </p> <p>Dear Client</p> <p>This is an automated response to confirm that we have received your request.</p> <p>Your reference number is ********** 560</p> <p>One of our Client Relationship Managers will attend to your request and respond via e-mail or contact you telephonically.</p> <p>Kindly note that, should your query be relate to 2015 claims or benefits, it will be forwarded to Metropolitan Health Group for assistance. If you wish to follow up on your 2015 query, please contact Metropolitan Health Group by e-mailing ********** or by contacting 0800 BANKMED (0 ********** ).</p> <p>Yours in good health<br /> Bankmed Medical Scheme<br /> Website: www.bankmed.co.za <br /> </p>