BESTMED USELESS
IF I COULD GIVE NO STARS TO BESTMED I WOULD! ABSOLUTELY USELESS!!!!!!!!!!!!!!!!!!!!!!!!!! I need to have a procedure done on my arm, a tendon synovectomy and I contacted Bestmed to get authorisation and was informed to get the following information: A clinical report from my doctor Letter stating my symptoms 12 month statement from my local GP doctor and finally ONLY a DAY procedure Hospital code
WHAT A ****ING JOKE!!!! They wont authorise for me to have the procedure at a normal hospital like Wilgeheuwel Hospital, they want everthing but a ****ing stool sample from me.. ****ING USELESS!!! But every month they take my monthly debit!!!!
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Bestmed Medical Scheme's replyOfficial
10 Oct 2023, 14:10Dear Lara
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk management and underwriting protocols.
Please understand that even if a procedure qualifies as a funded benefit, its authorisation depends on specific clinical criteria, protocols, and funding guidelines. Therefore, such requests are sent to our medical advisors for evaluation before approval can be confirmed.
Your case has been forwarded to our clinical advisory committee for review. Once the review is complete, we will update you with feedback.
As per scheme rules, If you opt to use a private hospital over a day clinic for a day procedure, a co-payment of R2500.00 will apply.
Regards
Nondumiso Letsoalo
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk management and underwriting protocols.
Please understand that even if a procedure qualifies as a funded benefit, its authorisation depends on specific clinical criteria, protocols, and funding guidelines. Therefore, such requests are sent to our medical advisors for evaluation before approval can be confirmed.
Your case has been forwarded to our clinical advisory committee for review. Once the review is complete, we will update you with feedback.
As per scheme rules, If you opt to use a private hospital over a day clinic for a day procedure, a co-payment of R2500.00 will apply.
Regards
Nondumiso Letsoalo
Bestmed Medical Scheme's reply10 Oct 2023, 14:10
Official
Dear Lara
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk management and underwriting protocols.
Please understand that even if a procedure qualifies as a funded benefit, its authorisation depends on specific clinical criteria, protocols, and funding guidelines. Therefore, such requests are sent to our medical advisors for evaluation before approval can be confirmed.
Your case has been forwarded to our clinical advisory committee for review. Once the review is complete, we will update you with feedback.
As per scheme rules, If you opt to use a private hospital over a day clinic for a day procedure, a co-payment of R2500.00 will apply.
Regards
Nondumiso Letsoalo
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk management and underwriting protocols.
Please understand that even if a procedure qualifies as a funded benefit, its authorisation depends on specific clinical criteria, protocols, and funding guidelines. Therefore, such requests are sent to our medical advisors for evaluation before approval can be confirmed.
Your case has been forwarded to our clinical advisory committee for review. Once the review is complete, we will update you with feedback.
As per scheme rules, If you opt to use a private hospital over a day clinic for a day procedure, a co-payment of R2500.00 will apply.
Regards
Nondumiso Letsoalo