SP
Sandra P

1 reviews | Active since Feb 2015

15 May 2017, 17:26

Claims not paid

<p>I struggled from 10 April 2017 to obtain authorisation for special feeds for the member, which was only given on 5 May. I had to buy these as finances and stock allowed. Now they refuse to pay due to the number of days between scripts. If you had a good look at these scripts you will see that we did not buy the full month's requirementof 28 at a time, but 4-5 at a time, which calculates to around 1 a day. This was not due to any negligence on my part. </p> <p> </p> <p>Get all the outstanding information from the service provider and resubmit these claims for payment to the member.</p>

0
Replies (10)
Bankmed
Bankmed's reply16 May 2017, 12:42
Official

Dear Sandra

Thank you for contacting us regarding this matter.

We will look into the details and will be in touch with feedback.

Regards
Bankmed Servicing

SP
Sandra P's update18 May 2017, 10:22
Reviewer Update

The only reply I have received from Bankmed is that they will not pay the script, as it was filled early. Please sort this out ASAP, because I need to get the balance of the script today, I do not have the necessary funds to continue to pay for something that you approved as PMB.

SP
Sandra P's update01 Jun 2017, 16:04
Reviewer Update

This complaint has been logged on 15 May and is still unresolved. The pharmacy can still not process the claims. Annelize Strydom has contacted myself and Sonja van Deventer at the pharmacy but if we try to get hold of her she is never available and does not respond in a reasonable time to our emails.

I am unable to provide the necessary care for my mother since Bankmed cannot sort this out. I want this matter finalised now.

Bankmed
Bankmed's reply01 Jun 2017, 17:08
Official

Hi Sandra

We will follow up with the relevant team and revert to you with feedback.

Regards

Bankmed Servicing Team

SP
Sandra P's update01 Jun 2017, 18:28
Reviewer Update

I have spoken to Sibongile this afternoon, who went out of her way to assist. She spoke to Palesa at Medikredit and I have also been in contact with Moot Hospital Pharmacy.

Bankmed
Bankmed's reply02 Jun 2017, 10:52
Official

Thank you for letting us know.

SP
Sandra P's update13 Jun 2017, 11:17
Reviewer Update

This matter is still unresolved. Promises of claims being processed within 24-48 hours and being paid immediately and my money which must be refunded is not being kept. The PRO has made promises that has not been kept.

Management is unable to comply with their own promises. How can you run a medical scheme on incompetence?

Bankmed
Bankmed's reply13 Jun 2017, 11:40
Official

Dear Sandra

We would really like to assist.

We will follow up with the relevant personnel and revert to you with feedback.

Regards

Bankmed Servicing Team

SP
Sandra P's update13 Jun 2017, 11:58
Reviewer Update

I am not interested with speaking to anybody who cannot ensure that the Pharmacy and myself will receive our money TODAY!!!!!!

I am not interested in any more empty promises. This matter has now dragged on long enough.

Bankmed
Bankmed's reply14 Jun 2017, 12:48
Official

Dear Sandra

Your concerns has been escalated to the highest point of escalation, you will receive final feedback from the said team and you are welcome to liaise with the team directly.

Regards

Bankmed Servicing Team