1 reviews | Active since Feb 2018
About to lose my job
I am on the verge of losing my job thanks to Bestmed. I had surgery done on the 04th of July 2023. Since then I've been drained mentally due to the lack of assistance from Bestmed. The anesthesiologist was short paid by R7000. I called on the 10th of July at 11.53 and the lady said that the all accounts will be settled, I shouldn't worry. Again, on the 12th of July 13.19, Nondumiso called me and assured me that as long as the treating Dr puts his claim through, all bills will be paid. She even offered to call the surgeon, nothing happened. The anesthesiologist is not threatening to list me on ITC. I work for a financial institution and will lose my job if this happens. Please can someone take ownership and call me ASAP. Preferably by 08.30 this morning. I suffer with depression and this isn't good for me, at all!
Please be informed that the anaesthesiology account has been settled at the scheme rate. However, there's a shortfall due to the doctor charging above the scheme rate. On 12/07/2023, we confirmed that payment would be made at 100% of scheme rate.
As indicated in your authorisation letter, if an anaesthetist charges above the scheme rate, there will be a shortfall for which the member is liable for non-PMB procedures. Unfortunately, we cannot review your claim for PMB (Prescribed Minimum Benefits) as the procedure is a non-PMB.
I contacted the doctor on 12/07/2023 regarding the claim. He mentioned a system issue but assured me of a prompt claim submission. As per scheme rules, the member is responsible for submitting claims promptly. We have yet to receive this claim. If not received within 4 months from the date of service, it will become stale.
Regards
Nondumiso Letsoalo
Please be informed that the anaesthesiology account has been settled at the scheme rate. However, there's a shortfall due to the doctor charging above the scheme rate. On 12/07/2023, we confirmed that payment would be made at 100% of scheme rate.
As indicated in your authorisation letter, if an anaesthetist charges above the scheme rate, there will be a shortfall for which the member is liable for non-PMB procedures. Unfortunately, we cannot review your claim for PMB (Prescribed Minimum Benefits) as the procedure is a non-PMB.
I contacted the doctor on 12/07/2023 regarding the claim. He mentioned a system issue but assured me of a prompt claim submission. As per scheme rules, the member is responsible for submitting claims promptly. We have yet to receive this claim. If not received within 4 months from the date of service, it will become stale.
Regards
Nondumiso Letsoalo