PS
Phiwo S
1 reviews | Active since Nov 2013
10 Dec 2018, 15:25
No customer service at all.
Last year I app**** for rituximab, which was rejected but was never given a reason why. In November I app**** for it again. I everytime I call bankmed I am told I must call in 2 days as the application was sent to MRT (the same ones who rejected the treatment with no reason).
How long must I wait for a response?????????????
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Replies (2)Bankmed's replyOfficial
10 Dec 2018, 16:47Hi Nosiphiwo
We will follow up on your request for Rituximab and provide you with feedback as soon as possible.
Regards,
The Bankmed Service Team.
We will follow up on your request for Rituximab and provide you with feedback as soon as possible.
Regards,
The Bankmed Service Team.
Bankmed's reply10 Dec 2018, 16:47
Official
Hi Nosiphiwo
We will follow up on your request for Rituximab and provide you with feedback as soon as possible.
Regards,
The Bankmed Service Team.
We will follow up on your request for Rituximab and provide you with feedback as soon as possible.
Regards,
The Bankmed Service Team.
PS
Phiwo S's updateReviewer Update
07 Jan 2019, 11:19Request for Rituximab for Lupus Nephritis
The request has been reviewed by the Bankmed Medical Review Team. Based on the clinical information received and the clinical evidence available for the treatment of Lupus Nephritis, the request for Rituximab has been declined as clinical entry criteria has not been met. There are alternative treatments available for the treatment of this condition.
We make consistent and fair funding decisions in the interest of all Scheme members
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. This process also helps us make decisions regarding which procedures and treatment to exclude from cover.
We recognise that the treating doctor is in the best position to make medical decisions regarding the treatment options available. In reaching this decision we have not questioned the diagnosis or the treatment recommended by the treating doctor.
We hope this clarifies the reasons for declining your request.
1. What criteria were not met (more expensive plan)?
2.Seeing that you so worried about funding I have moved from comprehensive to plus plan, so that I can get the treatment I need.
3.if you believe that my doctor is in the best position to make medical decisions regarding my treatment, then why have you blocking him from treating me for the past to years?
4.What alternative treatments? I have been using cell-cept and prograf which are not working. please recommend and approve what ever treatment you talking about so I can get on with my life.
5.Your email didn't clarify jack, instead made me ****ed.
PS
Phiwo S's update07 Jan 2019, 11:19
Reviewer Update
Request for Rituximab for Lupus Nephritis
The request has been reviewed by the Bankmed Medical Review Team. Based on the clinical information received and the clinical evidence available for the treatment of Lupus Nephritis, the request for Rituximab has been declined as clinical entry criteria has not been met. There are alternative treatments available for the treatment of this condition.
We make consistent and fair funding decisions in the interest of all Scheme members
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. This process also helps us make decisions regarding which procedures and treatment to exclude from cover.
We recognise that the treating doctor is in the best position to make medical decisions regarding the treatment options available. In reaching this decision we have not questioned the diagnosis or the treatment recommended by the treating doctor.
We hope this clarifies the reasons for declining your request.
1. What criteria were not met (more expensive plan)?
2.Seeing that you so worried about funding I have moved from comprehensive to plus plan, so that I can get the treatment I need.
3.if you believe that my doctor is in the best position to make medical decisions regarding my treatment, then why have you blocking him from treating me for the past to years?
4.What alternative treatments? I have been using cell-cept and prograf which are not working. please recommend and approve what ever treatment you talking about so I can get on with my life.
5.Your email didn't clarify jack, instead made me ****ed.
