1 reviews | Active since May 2023
Near death Emergency admission never authourised
Had the most traumatizing experience ever. Imagine paying medical aid as a new member one of the best options and on your first emergency situation they refuse to authorize an emergency. Rushed my sister to ER because she was vomiting blood at 11pm. Had to be admitted and a CT scan urgently needed. Only to be bombarded with scheme requests for doctors reports and all. Understandably admitting doctor and patient report were sent only to give us a hard time because they require a medical history from a gp she never had. The only history was from a local hospital which we gave as much info as we can and file numbers etc for them to try and get the records from their end as we had failed on our end. Had we informed them about preexisting conditions? YES! Was this a preexisting condition NO! Did police affidavits and all to no avail. Until now a week later Bestmed never authorised a near death experience! Will definately be switching to another Scheme!
Please accept our sincere apologies for the inconvenience caused.
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk-management and underwriting protocols.
Upon receipt of this information, the request for authorisation will be referred to the medical advisor for review, of which the standard turn-around time for feedback is 48 – 72 working hours.
Please note that while a procedure may be a funded benefit, authorisation is subject to specific clinical criteria, protocol's and funding guidelines. As such, requests are referred to our medical advisor for evaluation before approval can be granted. Scheme tariffs and option limits apply.
Katlego Sithole
Please accept our sincere apologies for the inconvenience caused.
In relation to the Bestmed Managed Healthcare admission protocol for members with less than 12 months of membership with Bestmed. The requested information is required as part of our risk-management and underwriting protocols.
Upon receipt of this information, the request for authorisation will be referred to the medical advisor for review, of which the standard turn-around time for feedback is 48 – 72 working hours.
Please note that while a procedure may be a funded benefit, authorisation is subject to specific clinical criteria, protocol's and funding guidelines. As such, requests are referred to our medical advisor for evaluation before approval can be granted. Scheme tariffs and option limits apply.
Katlego Sithole