1 reviews | Active since Mar 2015
Bankmed with the oh so ****py service again
Bankmed @ it again
My son went in for an op to remove half of his lung at Sandton Medi Clinic in Jan 2017. He was just under two years at the time. The op was required as he had an underlying condidition called ccam. Due to the lung being inflamed it was putting pressure on his heart and had to be removed.
We had been trough a journey with his surgeon who coached us through the the pregnancy as the condition was picked up pre birth. His surgeon moved to Sandton medi clinic and we natutally followed him due to the relationship we had built. His pead also practices at Sandton medi.
The 5 hour op was done in Jan 2017. Bankmed had paid all bills (surgeon, hospital, theater, anesthetics, icu etc). Bankmed however refused to pay the complete bill for the Doctors that run and manage the icu ward. The reason was that the surgery was elective and pre planned so we could do it at another hospital. We did not have a choice as to which doctors took care of my son while he was in ICU.
As he had a 5 hour op he required ICU which makes his stay a PMB in ICU. Its been a yeer and a few months later and this bill still hasnt been settled despite myself as well as the doctors group contacting bank med.
I work in the financial sector and have no option but to use this ****py medical aid.
I even asked the bankmed call centre agent if i was expected to wheel my two year old child out of a 5 hour op and transfer him to a hospital that would suit their requirements.
Seriously frustrated at the service that we receive from this organisation which takes advantage of us as we have no choice but to use them in the financial sector.
Dear zhameed
Please accept our sincere apologies for the delayed response and the frustration this has caused.
As a healthcare funder, we manage carefully planned funding guidelines to ensure the Scheme is able to cover claims now and into the future. Our role is to ensure members of the Scheme enjoy access to quality healthcare in a way that remains affordable and sustainable. Some of the ways we achieve this is in our plan and benefit design, the creation and application of funding policies and clinical protocols which are developed using a rigorous, evidence-based decision-making process.
Our Medical Review Team has declined funding for the claims in question the affected service dates from 24 January 2017 to 03 February 2017, as Prescribed Minimum Benefit at cost. This was a planned admission, therefore the claims paid as per the benefits on the your plan. The use of a non-designated service provider was voluntary. We are not insensitive to your plight in dealing with the situation, but hope that we have gained your understanding why it is unfortunately not possible to provide the outcome you were hoping for. We can however assure you that the Scheme is acting within the rules and regulation on your specific chosen plan type.
Should you require further details on this matter please contact ***3 alternatively email ***
Regards
Bankmed Servicing Team
Dear zhameed
Please accept our sincere apologies for the delayed response and the frustration this has caused.
As a healthcare funder, we manage carefully planned funding guidelines to ensure the Scheme is able to cover claims now and into the future. Our role is to ensure members of the Scheme enjoy access to quality healthcare in a way that remains affordable and sustainable. Some of the ways we achieve this is in our plan and benefit design, the creation and application of funding policies and clinical protocols which are developed using a rigorous, evidence-based decision-making process.
Our Medical Review Team has declined funding for the claims in question the affected service dates from 24 January 2017 to 03 February 2017, as Prescribed Minimum Benefit at cost. This was a planned admission, therefore the claims paid as per the benefits on the your plan. The use of a non-designated service provider was voluntary. We are not insensitive to your plight in dealing with the situation, but hope that we have gained your understanding why it is unfortunately not possible to provide the outcome you were hoping for. We can however assure you that the Scheme is acting within the rules and regulation on your specific chosen plan type.
Should you require further details on this matter please contact ***3 alternatively email ***
Regards
Bankmed Servicing Team