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Carolyn C

1 reviews | Active since Feb 2021

05 May 2021, 09:56

Request for PMB Benefits Declined-Customer Centricity Non Existent

As long standing members of Bestmed (38 years) experienced our first major medical event that resulted in an involuntary admission (PMB) for my Husband 25th January 2021. (Member Liable) R14 804.18 for the hospital and R2149.75 for the anesthetist. All Doctors charged Scheme rates. Effective 11th February have communicated both in writing, telephonically as well as the live chat portal. No effort whatsoever to assist Members, repetitive answer=Member Liable=Request for PMB benefits declined. All Schemes have rules, yet the manner in which this event has been handled is appalling, transferred from pillar to post, with no team leader, supervisor or manager investigating this PMB event and/or making a courteous effort to provide comprehensive feedback. After 38 years of membership do not feel like a valued member at all.

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Replies (2)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply05 May 2021, 11:51
Official
Hi Carolyn, please accept our sincere apologies for the inconvenience caused. The case has been escalated to the PMB supervisor for investigation and feedback to you. Regards, Katlego


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Carolyn C's update06 May 2021, 13:00
Reviewer Update
I have just received ambiguous and repetitive feedback yet again "PMB Declined" regarding the anesthetist account per the Tariff and Rules Department. Kindly substantiate as to why modifier in question is not applicable to the tariff, including which the monetary value indicated per your response is incorrect. Kindly provide the required information soonest in order to finalise my complaint submission to the Council of Medical Schemes (CMS)