Pathetic service

My daughter, Jo-Mari Stander (dependent 02) visited her GP on 09 November 2023 as well as 14 November 2023. The reason for her visits was relating to her major depression (claims were submitted under F32.2 a PMB condition) which is registered with Bankmed as a chronic condition. Each time she visits him for the aforementioned condition the claims get paid from her PMB benefit however the two service dates in question are trying to fund from Medical Savings. Since our savings was depleted by the time she visited the doctor the claims were rejected resulting in an outstanding balance with the doctor which to date has not been paid.

My daughter has contacted the medical aid on multiple occasions to rectify this and each time the consultants tell her that the claims have been referred to the back office team and that they will get back to her within 2 business days which never happens. All of the consultants she has spoken to at Bankmed have confirmed that no claim relating to PMB should be funding from the medical savings but instead from the members PMB however to date it is still trying to fund from the incorrect benefit.

As far as my knowledge, the rules and guidelines set out by the council for medical schemes state that no claim relating to a prescribed minimum benefit may funded from the member's day to day benefit yet this claim is trying to.

If this matter is not resolved by the end of the week I will be referring it to the council for intervention as this is becoming ridiculous.