NM
Naledi M

1 reviews | Active since Jul 2023

27 Jul 2023, 04:20

bestmed did me dirty

bestmed does not have MRI benefit. I REPEAT... BESTMED DOES NOT HAVE MRI BENEFIT. What you see on their brochure is just for attracting people. When I was at casualty they didn't pay for my claim because I was not admitted. I settled my medical bills myself . Then I got admitted and they wanted to do brain MRI. They rejected my authorization and they said I must do it as an out to avoid paying the full amount of brain mri. Now everything changed from your only covered when your admitted to you can only do it as out patient, biggest ****** in SA. Their reason is I have chronic headache, I'm still waiting for the recordIng of the call where Amanda said I have chronic headache. According to all the documents submitted to you, there is no where it says I have chronic headache. Even if Amanda had said I have chronic headache over the phone, but what is on paper is different. You were just waiting at the corner for someone to say something wrong just you can use that as an excuse not to authorize brain MRI. Doing mri using cash is around R6000 and when your using medical aid as an "outpatient" is way more than R12000 and bestmed only pays up to R5800 meaning that I'm liable for the balance of more than R6000. Obviously you will opt for doing it cash to avoid paying a huge balance. Si there is no benefit for MRI because they sat down, did their research and said the only way to get the customer to pay for their own mri is if we pay up R5800 and we should force customer to do it as outpatient. I only got discharged because they didn't want to authorize for admission days to be extended just so they can avoid to pay full amount of brain MRI. I was still not ok when I left the hospital. Even now it's been two weeks I'm still not okay because bestmed can lie and distort information to avoid paying yet everything without fail and stories they are being paid. Stay away from them. They are quick in rejecting claims. I still wonder if the claim for heart scan is paid. All they want is motivations from the Doctor why they should pay. Would a doctor do a procedure for fun? I also have to pay for the tools they used at theater??? Was it going to be better had I brought my own tools from home for them to use? Surely it wouldn't have been a problem. Are those beauty tools or medical tools? Please answer me because I'm confused why can't you pay for that? The amount of stress I have because bestmed

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Replies (1)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply27 Jul 2023, 12:41
Official
Dear Naledi, 

We sincerely apologize for the inconvenience caused.

as per our telephonic conersation, i have refered the case to the Hospital benefit Management Team Leaders for investigation and assistance with your case.

Regards
Katlego Sithole