SL
Sisi L
1 reviews | Active since Jun 2018
18 Sept 2024, 10:06
Poor authorization service
I’m really disappointed with the medical aid and how they dealt with authorization for an emergency. We comp**** with all the documentation they requested and they said they would respond within 48-72 hours. We are still waiting with no feedback. It’s unfortunate to deal with having to pay exorbitant hospital fees and paperwork especially in the middle of a health scare.
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Replies (4)0
Replies (4)
Bestmed Medical Scheme's replyOfficial
18 Sept 2024, 10:40 Dear Sisi Lwandle
Kindly be advised that, in relation to the Bestmed Managed Healthcare protocol for member's with less than 12 months of membership with Bestmed, we would like to request the following:
1. Please send a 12-month GP report including the dates, diagnosis and treatment received
2. A Clinical report from the treating Specialist
3. A letter from patient explaining signs and symptoms experienced, when it started, and if treated by a Dr or received any medication for this condition.
We have received the clinical reports and a letter from the member. We are currently awaiting the 12-month GP report.
Best regard
KB
Kindly be advised that, in relation to the Bestmed Managed Healthcare protocol for member's with less than 12 months of membership with Bestmed, we would like to request the following:
1. Please send a 12-month GP report including the dates, diagnosis and treatment received
2. A Clinical report from the treating Specialist
3. A letter from patient explaining signs and symptoms experienced, when it started, and if treated by a Dr or received any medication for this condition.
We have received the clinical reports and a letter from the member. We are currently awaiting the 12-month GP report.
Best regard
KB
Bestmed Medical Scheme's reply18 Sept 2024, 10:40
Official
Dear Sisi Lwandle
Kindly be advised that, in relation to the Bestmed Managed Healthcare protocol for member's with less than 12 months of membership with Bestmed, we would like to request the following:
1. Please send a 12-month GP report including the dates, diagnosis and treatment received
2. A Clinical report from the treating Specialist
3. A letter from patient explaining signs and symptoms experienced, when it started, and if treated by a Dr or received any medication for this condition.
We have received the clinical reports and a letter from the member. We are currently awaiting the 12-month GP report.
Best regard
KB
Kindly be advised that, in relation to the Bestmed Managed Healthcare protocol for member's with less than 12 months of membership with Bestmed, we would like to request the following:
1. Please send a 12-month GP report including the dates, diagnosis and treatment received
2. A Clinical report from the treating Specialist
3. A letter from patient explaining signs and symptoms experienced, when it started, and if treated by a Dr or received any medication for this condition.
We have received the clinical reports and a letter from the member. We are currently awaiting the 12-month GP report.
Best regard
KB
SL
Sisi L's updateReviewer Update
18 Sept 2024, 11:08Hi KB. Thank you for the prompt response. The GP had advised that they sent this report. I will follow up.
SL
Sisi L's update18 Sept 2024, 11:08
Reviewer Update
Hi KB. Thank you for the prompt response. The GP had advised that they sent this report. I will follow up.
Bestmed Medical Scheme's replyOfficial
18 Sept 2024, 12:28 Dear Sisi Lwandle
We appreciate your understanding regarding the delay in processing your authorization request.
As soon as we receive the outstanding document, we will review your authorization and provide you with a feedback.
Best regards
KB
We appreciate your understanding regarding the delay in processing your authorization request.
As soon as we receive the outstanding document, we will review your authorization and provide you with a feedback.
Best regards
KB
Bestmed Medical Scheme's reply18 Sept 2024, 12:28
Official
Dear Sisi Lwandle
We appreciate your understanding regarding the delay in processing your authorization request.
As soon as we receive the outstanding document, we will review your authorization and provide you with a feedback.
Best regards
KB
We appreciate your understanding regarding the delay in processing your authorization request.
As soon as we receive the outstanding document, we will review your authorization and provide you with a feedback.
Best regards
KB
SL
Sisi L's updateReviewer Update
21 Oct 2024, 13:22After a prolonged back and forth, I was advised that the claim was processed but I never received any payment confirmation or claims statement. I queried this and now I’ve been told to resubmit everything. Mind you, this will be the fourth resubmission. Please advise:
Ticket number: E61C507677A2A
Reference email:
Dear Sir/Madam Thank you so much for your e-mail of 16 October 2024. I welcome the opportunity to be of service to you and to respond as follows to your query: Kindly note the claim for services rendered on 12 September 2024 for Hillcrest Private Hospital was electronically received. The claim was processed and accepted for payment to you for the next payment run which will be on 17 October 2024. The statement will be e-mailed to you to the e-mail address which is registered with the Scheme once it becomes available. I trust you will find this feedback useful. If, however, you need more information, or support from our Client Relations Communication Team, please do not hesitate to contact us again. Your wellbeing, as a valued client of the Scheme, is important to all of us at Bestmed.
Ticket number: E61C507677A2A
Reference email:
Dear Sir/Madam Thank you so much for your e-mail of 16 October 2024. I welcome the opportunity to be of service to you and to respond as follows to your query: Kindly note the claim for services rendered on 12 September 2024 for Hillcrest Private Hospital was electronically received. The claim was processed and accepted for payment to you for the next payment run which will be on 17 October 2024. The statement will be e-mailed to you to the e-mail address which is registered with the Scheme once it becomes available. I trust you will find this feedback useful. If, however, you need more information, or support from our Client Relations Communication Team, please do not hesitate to contact us again. Your wellbeing, as a valued client of the Scheme, is important to all of us at Bestmed.
SL
Sisi L's update21 Oct 2024, 13:22
Reviewer Update
After a prolonged back and forth, I was advised that the claim was processed but I never received any payment confirmation or claims statement. I queried this and now I’ve been told to resubmit everything. Mind you, this will be the fourth resubmission. Please advise:
Ticket number: E61C507677A2A
Reference email:
Dear Sir/Madam Thank you so much for your e-mail of 16 October 2024. I welcome the opportunity to be of service to you and to respond as follows to your query: Kindly note the claim for services rendered on 12 September 2024 for Hillcrest Private Hospital was electronically received. The claim was processed and accepted for payment to you for the next payment run which will be on 17 October 2024. The statement will be e-mailed to you to the e-mail address which is registered with the Scheme once it becomes available. I trust you will find this feedback useful. If, however, you need more information, or support from our Client Relations Communication Team, please do not hesitate to contact us again. Your wellbeing, as a valued client of the Scheme, is important to all of us at Bestmed.
Ticket number: E61C507677A2A
Reference email:
Dear Sir/Madam Thank you so much for your e-mail of 16 October 2024. I welcome the opportunity to be of service to you and to respond as follows to your query: Kindly note the claim for services rendered on 12 September 2024 for Hillcrest Private Hospital was electronically received. The claim was processed and accepted for payment to you for the next payment run which will be on 17 October 2024. The statement will be e-mailed to you to the e-mail address which is registered with the Scheme once it becomes available. I trust you will find this feedback useful. If, however, you need more information, or support from our Client Relations Communication Team, please do not hesitate to contact us again. Your wellbeing, as a valued client of the Scheme, is important to all of us at Bestmed.