LJ
Lauren J

1 reviews | Active since Dec 2018

21 Dec 2018, 15:15

Disgusted in the response received from PMB representitive

I made an application to PMB services for Physiotherapy for my disabled son who had a near fatal drowning incident a few years ago. I've been trying to get November / December Physiotherapy sessions paid for by the scheme through PMB as this is a need not a want for him. This was the response from your PMB representative:

Good day, Thank you for enquiring with the PMB department. The request was previously declined by Clinical Advisory team. Life-long physiotherapy is not PMB level of care. The child has been receiving physiotherapy throughout the year and still no improvement. Thus, the services declined for PMB funding.

Penelope Mathebula PMB Assistant

The response I received was quite frankly uninformed, distasteful and clearly that of an inexperienced person who should not be working with life or death claims. In my opinion this person clearly never even took the time to go through the thorough application made by our Physiothe******. Physiotherapy for Cerebral Palsy children are a necessity, the lack of therapy can lead to a host of complications. What the right does this person have to tell me there has been no improvement? On what basis, or to what is my son being compared to? Is there a baseline of “no improvement” ? If so it’s fine to decline. Previous PMB applications were declined due to me still having funds. Now I get this? The reason for me placing this review of the medical aid is simply to educate the scheme of the lack of knowledge around the need for physiotherapy for children with cerebral palsy, and also the fact that every PMB case should be dealt with on its own merit. I would appreciate a response as this is the worse response I could ever have ever received about my son from the medical scheme I have been with for more than 10years.

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Replies (1)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply21 Dec 2018, 15:38
Official
Good day Ms Jordaan

Your complaint will be forwarded to Management for investigation and a response to you.

Thank you for bringing this matter to our attention.

Kind regards.

Bestmed