BM
Buke M

1 reviews | Active since Jan 2010

12 Oct 2017, 09:47

Claims for pre-approved treatment rejected several times

Can someone please help as I am getting tired of following up on the issue weekly, get promised feedback and action but only to get the claims rejected every week.

This email address given, ********** ,to me to use for sending claims for the approved treatment only sends automated email messages. I have sent several emails to this address and not once have I received any valid response.

Last week I spoke to another consultant and Ntombi several times. Ntombi assured me that the outstanding claims for OT and Speech Therapy will be re-processed, approved and be on the payment run scheduled for the past Sunday and should receive the money in my account by Wednesday the 11th of October. Waited for Wednesday and only to receive an email that the claims have been rejected.

I truly believe Discovery and the scheme BankMed is taking me for a ride. How can a claim I submitted at the beginning of September for August sessions still be outstanding in the middle of October? I even sent two more claims and all of them get rejected. The benefits for both OT and Speech have been approved for my daughter but all three invoices submitted for claim subsequent to the benefits being approved get declined! What must I do when this is clearly the worst service ever? Call the contact centre once again to relay the same story and listen to different people ‘apologising’, make promises and then still not re-imburse me for the claims?

I need Discovery/BankMed to reimburse me for those claims today and I do not want to hear any more empty promises. The treatment has been approved and I find it very difficult to understand why claims for the pre-approved treatment always get rejected even when I call in weekly and send follow up emails.

Membership number: ********** 50

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Replies (4)
Bankmed
Bankmed's reply12 Oct 2017, 12:21
Official

Hi Buke, thank you for taking our call, we apologise for the frustration. We will look into this matter and revert with feedback. Regards

BM
Buke M's update18 Oct 2017, 11:20
Reviewer Update
My long-outstanding claims were finally supposed to be paid at the latest last week Wednesday. When I spoke to Ntombi last week, she said there was a system glitch and the payment would be effected. It’s a week later and the claims still not reimbursed, am I meant to still believe that BankMed/Discovery is still sorting out the system glitch for the entire week? Tinyiko also contacted me and promised to follow up with me. It's Wednesday, my query still not addressed and have not heard anything from both Ntombi and Tinyiko!
Bankmed
Bankmed's reply19 Oct 2017, 17:41
Official

Hi Mabuke, we’ve tried calling on the number we have on record however, you were unavailable to take our call. Please can you confirm an appropriate time for us to speak regarding your concerns raised. Regards

Bankmed
Bankmed's reply23 Oct 2017, 18:00
Official

Hi Mabuke, We apologise for the delayed response, we’ve confirmed that you have been contacted and assisted. An email correspondence was sent to you, you may respond directly to it for further assistance on the matter. Regards