MH
Mushhooda H

1 reviews | Active since Mar 2017

03 May 2019, 10:17

Pathetic service!

So I wrote on here before, about a month ago and I am still waiting on an response. And below is what I said. So I am extremely unhappy with my medical aid. I had an emergency c-section on the 11 February 2019. And I received my statement from the medical aid showing an amount of R21245.92 which was claimed but only R5661.92 was paid. Now to me that is ridiculous! Especially for all the money we've been paying for the last 12+ years. I called the medical aid spoke to 2 different people who gave me 2 different conflicting stories. 1 was that an incorrect code was submitted for the emergency c-section and 2 was that it could not have been an emergency as the gynaecologist is on call 24/7 (I mean really, what gynaecologist is on call 24/7). To me it just seems that it's much easier for the medical aid to just brush one off and expect you as the client to just accept whatever they say. The senior person even had the nerve to tell me but you knew the service provider was not fully covered by the medical aid, of which I did yes. But when I was looking for a gynaecologist last year I was on the Traditional plan and to my surprise there isn't any gynaecologists that are fully covered, all of them was partial cover. Which is absurd! So you tell me what was I supposed to do?? All the medical is good for is just milking people and not providing any kind of service! I would have thought that because it was an emergency c-section that they would take that into consideration when my claim was submitted but no. Honestly if I could switch to a different medical aid I would because it's just endless problems and so many restrictions!

0
Replies (1)
Bankmed
Bankmed's reply03 May 2019, 13:11
Official
Hi Mushhooda

Please accept our sincere apologies for the frustration caused. We will follow up on this matter and provide you with feedback shortly.

Regards,
The Bankmed Service Team.