1 reviews | Active since Apr 2013
DISAPPOINTED WITH BESTMED MEDICAL AID
I am very disappointed with BESTMED MEDICAL AID. I went to the dentist on the 23 February 2024. My son is suffering decay, the whole Dec he was complaining that his teeth were painful and I was suffering bleeding gums and sensitivity especially when I am eating citrus fruit, vinegar, and drinking cold soda's. I had to change my tooth paste and brushes still i was suffering until someone said go wash your teeth see if it will improve. Guess what now we are both happy. The dentist told me that the claim was declined. I mean I last went to the dentist 2023 and now I encountered a problem. Bare in mind that my son was suffering since December. if I am not allowed to use my 2024 dental services when I have a problem who is going to use it? Why must I wait for 6 months to solve a problem that is happening now when i am paying every month? Basically with Bestmed wait 6 months in order for them to attend to your problem while you are suffering on the other side you are paying without fail. My medical aid number is ***0.
Please be informed that codes 8101 (oral examination) and 8159 (scaling and polishing) can only be charged once every six months. For follow-up consultations, they can use code 8104.
According to the South African Dental Association (SADA), there is a six-month cycle for these codes, and we are unable to override these rules. It's important to note that payments for the same codes were made last year in September and November.
Regards
Nondumiso
Please be informed that codes 8101 (oral examination) and 8159 (scaling and polishing) can only be charged once every six months. For follow-up consultations, they can use code 8104.
According to the South African Dental Association (SADA), there is a six-month cycle for these codes, and we are unable to override these rules. It's important to note that payments for the same codes were made last year in September and November.
Regards
Nondumiso
Kindly note that in front of my eyes this medical aid does not cater for emergency medical care I guess it's time to shop around if you are telling to wait six months to attend to issues that are threatening my health.
What is code 8104 used for and since i have to inform Bestmed when i am consulting for dental care when can I go for check up?
Kindly note that in front of my eyes this medical aid does not cater for emergency medical care I guess it's time to shop around if you are telling to wait six months to attend to issues that are threatening my health.
What is code 8104 used for and since i have to inform Bestmed when i am consulting for dental care when can I go for check up?
Please note that these regulations are set forth by SADA, and we cannot override them. Adherence to these regulations is mandatory within the medical scheme framework.
If there's a rule attached to a procedure code, we will process the claim according to that rule. This means that any specific guidelines or requirements associated with a particular procedure code will be followed meticulously during the claim processing procedure. Our commitment is to ensure that each claim is handled in accordance with the rules and regulations governing the medical scheme, thereby maintaining fairness and consistency in our processes.
While you are allowed to consult with a dentist at any time, it's important to note that the scheme will process and pay the claims in accordance with established protocols and guidelines. Additionally, coverage for dental services is subject to the availability of benefits within your plan.
Please note that these regulations are set forth by SADA, and we cannot override them. Adherence to these regulations is mandatory within the medical scheme framework.
If there's a rule attached to a procedure code, we will process the claim according to that rule. This means that any specific guidelines or requirements associated with a particular procedure code will be followed meticulously during the claim processing procedure. Our commitment is to ensure that each claim is handled in accordance with the rules and regulations governing the medical scheme, thereby maintaining fairness and consistency in our processes.
While you are allowed to consult with a dentist at any time, it's important to note that the scheme will process and pay the claims in accordance with established protocols and guidelines. Additionally, coverage for dental services is subject to the availability of benefits within your plan.