HG
Heinz G

1 reviews | Active since Jan 2024

29 Jan 2024, 23:36

Disappointing service

I am writing to express my profound disappointment and dissatisfaction with the service provided by Bestmed.

On June 18th, 2023, my fiancée joined my membership with high hopes for comprehensive healthcare coverage. However, our experience has been marred by significant setbacks and frustrations.

On July 31st, she visited the doctor due to irregular spotting, only to discover that she was 11 weeks pregnant. This revelation came as a surprise, considering she had experienced her normal menstrual cycle at the end of May and light bleeding in June. Which didn't come as a concern at the time, as it has happened before.

Initially, Bestmed covered the first consultation, but subsequent claims were inexplicably denied. Despite multiple attempts to understand the situation, we were met with vague explanations and contradictory information. The absence of a late joiner fee or clear communication about exclusions and waiting periods only added to our confusion and frustration.

Upon further inquiry, we were informed that the denial was due to discrepancies in the doctor's report, which failed to mention crucial details about my fiancée's previous cycles. Determined to rectify the situation, we promptly provided corrected information to Bestmed on January 10th, expecting a timely resolution.

However, the promised turnaround time of 3-5 working days was extended to 10-15 days without prior notice. Despite numerous follow-ups, including escalation to a medical advisor, we received no satisfactory response by January 26th.

As the due date of our baby approached, I personally reached out to Bestmed on January 29th, seeking clarity and resolution. To my dismay, I was met with unhelpful responses and a threat to terminate our membership if further inquiries were made.

It is deeply disappointing to pay for a service that fails to deliver when needed the most. I strongly caution others against choosing Bestmed, as our experience has left us not only frustrated but with a heap of debt.

In light of these events, I urge Bestmed to re-evaluate its policies and practices to ensure that members receive the support and coverage they deserve. Until then, I am left with no choice but to reconsider my affiliation with Bestmed.

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Replies (2)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply30 Jan 2024, 08:34
Official
Dear Heinz Gerber

We sincerely apologize for the treatment you experienced with our service.

I have escalated your complaint to our non-disclosure committee, and we will provide you with feedback once finalized.

Regards
Nondumiso
HG
Heinz G's update27 Mar 2024, 18:41
Reviewer Update
Here we go again.

Bestmed's incompetence knows no bounds. Despite having already undergone and paid for bloodwork a week prior, they audaciously resend us for the same tests after denying coverage for our pregnancy. Knowing full well that Bestmed washes their hands of anything pregnancy-related, we understandably refuse the redundant test during our check-up. But Bestmed persists, insisting we redo the bloodwork, adding insult to injury.

Fast forward a few weeks, and we're hit with an unexpected call from Ampath, demanding payment for the bloodwork. Bestmed's excuse? "These tests were crucial for making a fair and informed decision regarding the waiting period for pregnancy." Conveniently, they reject coverage due to "depleted benefits," leaving us to foot the bill.

Despite bloodwork being covered under our medical aid, Bestmed conveniently shifts the burden onto us because they didn't approve our pregnancy. According to them, since they declined coverage, we're now responsible for the unpaid claims.

But here's the kicker: Bestmed refuses to acknowledge the initial report from the doctor and instead insists on wasting resources by repeating tests unnecessarily. Why not utilize the already existing report for the bloodwork? Oh, right, because that would require logic and integrity, qualities sorely lacking at Bestmed.

This is just another example of Bestmed's blatant disregard for their members' well-being, bending and manipulating rules to suit their own agenda while leaving their customers in the lurch.

Nondumiso, thank you for not resolving or coming back to me after how many attempts to contact you. Please don't waist my time further with your escalating to the committee, I refuse to pay this bill.