CS
Chantel S
1 reviews | Active since Jun 2019
08 Jun 2022, 14:15
Authorization pending
Ive been on the phone with Bestmed for 2 days requiring authorization and i messages back they need to investigate which can take 48-72 hours i sent in ALL paperwork from pharmacies , Drs etc my surgery is tomorrow i was on Bestmed for years, off a year now back on and i need all this investigation done for surgery that is urgently needed i have 2 children i have had to take out of school due to my sleep deprivation falling asleep behind the wheel who can i speak to to get authorization ASAP
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Replies (3)
Bestmed Medical Scheme's replyOfficial
09 Jun 2022, 11:32Dear Chantel,
We sincerely apologize for the inconvenience caused.
The request for the planned procedure was received on 07 June 2022 for a procedure that was due on 09 June 2022.
The information supp**** was referred to the clinical advisory committee for evaluation, which takes 48-72 working hours for finalization and feedback.
However, i have escalated the request to the Hospital Benefit Management Department for urgent finalization and feedback to you.
Please note that according to the rules of the scheme ANNEXURE B.1, section 1.2:
▪ In the event of planned major operations and dental procedures, Members are advised to obtain Pre-Authorisation at least 2 (two) weeks in advance to ensure that the Member is aware of applicable benefits, limits, network restrictions, etc., before the event.
▪ In an emergency, on the 1st (first) working day after admission to a hospital, or at the first reasonable opportunity as may be determined by the Scheme.
- Late authorizations will be subject to, but not limited to, clinical review, application of rules, benefits, protocols, funding guidelines, as well as the PMB status of the services rendered.
Regards
Katlego Ratau
We sincerely apologize for the inconvenience caused.
The request for the planned procedure was received on 07 June 2022 for a procedure that was due on 09 June 2022.
The information supp**** was referred to the clinical advisory committee for evaluation, which takes 48-72 working hours for finalization and feedback.
However, i have escalated the request to the Hospital Benefit Management Department for urgent finalization and feedback to you.
Please note that according to the rules of the scheme ANNEXURE B.1, section 1.2:
▪ In the event of planned major operations and dental procedures, Members are advised to obtain Pre-Authorisation at least 2 (two) weeks in advance to ensure that the Member is aware of applicable benefits, limits, network restrictions, etc., before the event.
▪ In an emergency, on the 1st (first) working day after admission to a hospital, or at the first reasonable opportunity as may be determined by the Scheme.
- Late authorizations will be subject to, but not limited to, clinical review, application of rules, benefits, protocols, funding guidelines, as well as the PMB status of the services rendered.
Regards
Katlego Ratau
Bestmed Medical Scheme's reply09 Jun 2022, 11:32
Official
Dear Chantel,
We sincerely apologize for the inconvenience caused.
The request for the planned procedure was received on 07 June 2022 for a procedure that was due on 09 June 2022.
The information supp**** was referred to the clinical advisory committee for evaluation, which takes 48-72 working hours for finalization and feedback.
However, i have escalated the request to the Hospital Benefit Management Department for urgent finalization and feedback to you.
Please note that according to the rules of the scheme ANNEXURE B.1, section 1.2:
▪ In the event of planned major operations and dental procedures, Members are advised to obtain Pre-Authorisation at least 2 (two) weeks in advance to ensure that the Member is aware of applicable benefits, limits, network restrictions, etc., before the event.
▪ In an emergency, on the 1st (first) working day after admission to a hospital, or at the first reasonable opportunity as may be determined by the Scheme.
- Late authorizations will be subject to, but not limited to, clinical review, application of rules, benefits, protocols, funding guidelines, as well as the PMB status of the services rendered.
Regards
Katlego Ratau
We sincerely apologize for the inconvenience caused.
The request for the planned procedure was received on 07 June 2022 for a procedure that was due on 09 June 2022.
The information supp**** was referred to the clinical advisory committee for evaluation, which takes 48-72 working hours for finalization and feedback.
However, i have escalated the request to the Hospital Benefit Management Department for urgent finalization and feedback to you.
Please note that according to the rules of the scheme ANNEXURE B.1, section 1.2:
▪ In the event of planned major operations and dental procedures, Members are advised to obtain Pre-Authorisation at least 2 (two) weeks in advance to ensure that the Member is aware of applicable benefits, limits, network restrictions, etc., before the event.
▪ In an emergency, on the 1st (first) working day after admission to a hospital, or at the first reasonable opportunity as may be determined by the Scheme.
- Late authorizations will be subject to, but not limited to, clinical review, application of rules, benefits, protocols, funding guidelines, as well as the PMB status of the services rendered.
Regards
Katlego Ratau
CS
Chantel S's updateReviewer Update
09 Jun 2022, 11:38Thank you so much, really appreciate it
CS
Chantel S's update09 Jun 2022, 11:38
Reviewer Update
Thank you so much, really appreciate it
CS
Chantel S's updateReviewer Update
12 Jun 2022, 11:36Still not impressed my authorization was declined for something i never mentioned in the illness list i marked NO and the person that did my application didn't read correctly
CS
Chantel S's update12 Jun 2022, 11:36
Reviewer Update
Still not impressed my authorization was declined for something i never mentioned in the illness list i marked NO and the person that did my application didn't read correctly