NM
Naledi M

1 reviews | Active since Jul 2023

13 Jul 2023, 10:02

Got discharged because bestmed don't want to pay and they are ****s

I just got discharged while a doctor is not done doing all medical procedures simply because bestmed don't want to pay for my MRI brain scan. I'm typing this while lying on the hospital bed feeling so helpless and distressed because I don't have trust anymore that all my hospital claims will be covered. I have the hospital plan that clearly stipulated that specialized MRi and Cat scans are covered 100% scheme tariff. They even went to the extent of lying and changing my diagnose saying that I have a chronic headache, so they actually want to say I had this condition long before I joined the medical and that is a blatantly lie. While I was admitted had to make phone calls to them to find out why my claim for heart scan is rejected and why brain MRI authorization is not approved. They then rejected my approval to extend my admission days simply because they didn't want to pay for brain MRI. They want me to do it as an out patient so I can pay the balance from own pocket. If they find that I have a brain condition at the later stage, which is something that could have been prevented while I was hospitalized who will be held accountable for that? In April I was at casualty, none of my claims were paid I was told I'm only covered when I'm admitted. I understood that and paid all the costs. Now it was emergency admission, I'm no longer covered for brain MRI I must do it as out patient. They contradicting themselves just so they can avoid paying. These people are ****s and they say they want motivation from the Doctor for the heart scan claim and MRI but they declined for admission to be extended. If you really care about your health dont join bestmed. Been typing this since yesterday while at the hospital, now I'm at home and I can feel im still not well. I thought bestmed was better than Discovery but it's actually worse.

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Replies (2)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply13 Jul 2023, 13:33
Official
Dear Amanda

Kindly be informed that Amanda from radiology called for authorisation and told us you have a chronic headache.

We requested the following to review for the requested scans:

 - Clinical report for why the CT Angiography was requested.
 - CT Angiography report.
 - Clinical report for why an MRI of the brain is requested. 

Regarding your extended stay in the hospital, we also requested detailed clinical information from the hospital. 

Until now, we have not received any of the above-mentioned information. We can only review the case once we have received this information.

Your well-being, as a valued client of the Scheme, is important to all of us at Bestmed. 

Regards 
Nondumiso Letsoalo
NM
Naledi M's update15 Jul 2023, 16:56
Reviewer Update
Where is the recordIng of the call where Amanda said I have a Chronic head? Where do you expect to get clinic report when I had to leave the hospital as a result of you not approving the extension of my admission days?