Item: Bankmed
Rating: 1

Bankmed's replyOfficial

18 Oct 2017, 11:36

Morning Anna, we will look into this matter and will be in touch to address your concerns. Regards

Best regards,

Bankmed's reply18 Oct 2017, 11:36

Official

Morning Anna, we will look into this matter and will be in touch to address your concerns. Regards

Best regards,

Bankmed's replyOfficial

20 Oct 2017, 16:00

Hi Anna, we apologise for the frustration experienced by yourself when dealing with Bankmed Medical Scheme. We’ve confirmed that the query was discussed with you previously at length. Our Clinical Department reviewed the claim dated 28 September 2017 for Dr. C Kassianides and have confirmed that the claim was funded in line with the Scheme rules as you made use of a specialist who is not part of the Bankmed Specialist Network. The Scheme has an obligation to apply the rules fairly and consistently across the entire membership base and this is why you received consistent responses to your various requests in this regard. We are not insensitive to your plight in dealing with the situation, but hope that we have gained your understanding why the claim was funded in this way. Regards

Best regards,

Bankmed's reply20 Oct 2017, 16:00

Official

Hi Anna, we apologise for the frustration experienced by yourself when dealing with Bankmed Medical Scheme. We’ve confirmed that the query was discussed with you previously at length. Our Clinical Department reviewed the claim dated 28 September 2017 for Dr. C Kassianides and have confirmed that the claim was funded in line with the Scheme rules as you made use of a specialist who is not part of the Bankmed Specialist Network. The Scheme has an obligation to apply the rules fairly and consistently across the entire membership base and this is why you received consistent responses to your various requests in this regard. We are not insensitive to your plight in dealing with the situation, but hope that we have gained your understanding why the claim was funded in this way. Regards

Best regards,

's updateReviewer Update

22 Oct 2017, 11:01

What you forgot to mention is that the only provider within the bankmed scheme rate was far away from my house, 30km. And you have very few providers in your network to the point that one is unable to use your network providers and has no alternative but go to providers who are not contracted with Bankmed. The only reason I can think why you would have only one gastro which is very far is probably because your scheme rate is out of touch with the rates most private doctors are charging. Its a different thing if you had various providers nearby and I chose to go to one which is not in your network. In this case, you had no provider in my area. I gain, will ask that you consider your position in this matter as its very unfair. You did not have a provider in my area & don't behave as if you had a number of them and I willingly chose one out of the network.

's update22 Oct 2017, 11:01

Reviewer Update

What you forgot to mention is that the only provider within the bankmed scheme rate was far away from my house, 30km. And you have very few providers in your network to the point that one is unable to use your network providers and has no alternative but go to providers who are not contracted with Bankmed. The only reason I can think why you would have only one gastro which is very far is probably because your scheme rate is out of touch with the rates most private doctors are charging. Its a different thing if you had various providers nearby and I chose to go to one which is not in your network. In this case, you had no provider in my area. I gain, will ask that you consider your position in this matter as its very unfair. You did not have a provider in my area & don't behave as if you had a number of them and I willingly chose one out of the network.

Bankmed's replyOfficial

24 Oct 2017, 11:29

Hi Anna, we are truly sorry that we unable to provide you with your desired feedback however your request has been reviewed at the highest level and the decision remains unchanged, we can assure you that the Scheme is acting within the rules and regulation on your specific chosen plan type. Regards

Best regards,

Bankmed's reply24 Oct 2017, 11:29

Official

Hi Anna, we are truly sorry that we unable to provide you with your desired feedback however your request has been reviewed at the highest level and the decision remains unchanged, we can assure you that the Scheme is acting within the rules and regulation on your specific chosen plan type. Regards

Best regards,

Refused Claim