1 reviews | Active since Mar 2009
Hiding behind rules without considering the merit of the case!
I have had fillings in my tooth but it kept breaking further resulting in a bigger filling each time. The tooth has now broken t such an extent that you can literally see less than a quarter of the tooth. This has cased him severe toothache & the sharpness of the piece of the tooth left is cutting into the inside of my cheeks & my tongue.
I went for a panoramic X-ray upon referral from the dentist & after examining it, the dentist said it will be best to surgically remove the tooth. No we know that oral surgery is reserved for kids aged up to 7, however, this is a special case which the dentist has written a very detailed motivation to the Scheme & it was submitted together with the X-ray. BestMed has declined this request probably without considering the merits of the case.
If the tooth could have been extracted in the rooms, I would have done so but its impossible with such a little of the tooth protruding outside the gum - it needs to be surgically removed.
I work for a medical aid company & have for many years. When we received such requests, especially when the doctor motivates due to it being a special case, we don't hide behind rules but look at each case individually on merit & will grant the authorisation when the situation calls for it. Clearly the motivation from my dentist & the panoramic X-ray were not considered at all by WORSTmed!
Please note that we will be terminating our membership with this scheme!!!!!!!!!!!!!!!! USELESS!
I work for a medical aid company & have for many years. When we received such requests, especially when the doctor motivates due to it being a special case, we don't hide behind rules but look at each case individually on merit & will grant the authorisation when the situation calls for it. Clearly the motivation from my dentist & the panoramic X-ray were not considered at all by WORSTmed!
Please note that we will be terminating our membership with this scheme!!!!!!!!!!!!!!!! USELESS!
