SM
Sibongiswa M

1 reviews | Active since Jan 2011

20 Feb 2016, 11:36

Rejected claim

I phoned Bankmed to find out if they still have the benefit for contraceptives. I was told that the benefit is still there, I was advised that I can get a script and go to the pharmacy to get my oral contraceptive. I went to my GP and got the script and took it to Dischem but I was told that the medicine is not on the list. I called Bankmed and I was told that there is a problem with the system and the pharmacies are unable to process claims since they do not have the fomulary as yet. I called Bankmed again and I was told to send the reciept and the statement as proof that I have paid for the medication. I sumbitted the required documents and the claim was rejected by bankmed with the reason that the medicine is not on the list. I phoned again and enquired and I was told that the claim the claim that was sent by me has not been processed as yet and I must re-send the documents and the claim will be approved. I am extremely dissapointed with the service from Bankmed especially after the changes, it seems as if they do not know what they are doing and I also feel that I was misled by the consultants at the call centre. I am not prepared to pay for those pills for the next six months

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Replies (1)
Bankmed
Bankmed's reply24 Feb 2016, 10:08
Official
Hello Sihlem,

Thank you for your comment.

We've confirmed that the contraceptive you are taking is on the formulary and will be covered on your plan. The claim in question has been processed accordingly and the funds should reflect in your account within the next 3 to 5 working days. We apologise for any inconvenience caused by this matter.

You're welcome to contact us on 0800 BANKMED (***3) or email *** should you require any further assistance.

Regards
Annelize
Bankmed Servicing