tT
tmagopane T
1 reviews | Active since Sept 2016
18 May 2022, 09:57
Unable to claim back my money
My worst nightmare, Poor service, poor medical aid scheme. I have been trying to claim my money back for the past 2 months and they keep on decline my claims due to either more information is needed or because they don't know what was the diagnosis for. I mean if more information is required what's so hard to pick the phone and call the Doctor's office and not just decline the claims. I pay the medical aid every month and what frustrates me is that this was my first time using the medical aid since I've had it and had to pay cash out of my pocket. When I submit claims they get declined. I am done with Bestmed.
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Bestmed Medical Scheme's replyOfficial
18 May 2022, 13:29Hi Tshiamo,
we apologize for the inconvenience caused.
Kindly be informed that the invoice received is missing important information that is required to finalize the account.
Please note that communication was sent to the service provider on 06-May-22 and we are yet to receive feedback with an amended account containing all the required information.
In terms of the Medical Schemes Act and the Rules of Bestmed, a service provider must provide a medical scheme patient with a fully specified tax invoice within 30 days of a service being rendered. The tax invoice must contain – amongst others – at least the following information:
we apologize for the inconvenience caused.
Kindly be informed that the invoice received is missing important information that is required to finalize the account.
Please note that communication was sent to the service provider on 06-May-22 and we are yet to receive feedback with an amended account containing all the required information.
In terms of the Medical Schemes Act and the Rules of Bestmed, a service provider must provide a medical scheme patient with a fully specified tax invoice within 30 days of a service being rendered. The tax invoice must contain – amongst others – at least the following information:
(a) The surname and initials of the member;
(b) The first name and other initials, if any, and the date of birth of the patient;
(c) The name of the Scheme;
(d) The membership number;
(e) The practice number, name, and address of the supplier of service;
(f) The date on which each service was rendered;
(g) The relevant diagnostic (ICD 10 code) and such other item code numbers that relate to such services;
(h) The nature and cost of each relevant health service rendered, including the supply of medicine to the member concerned or to a dependant of that member; and the name, NAPPI code, quantity and dosage of, and net amount charged by the service provider in respect of the medicine;
(i) Where a pharmacist supplies medicine according to a prescription to a member or to a dependant of a member of a the Scheme, a copy of the original prescription or a certified copy of such prescription if the Scheme requires it;
You are kindly requested to obtain the fully specified tax invoice from the service provider and to resubmit the claim to Bestmed.
Regards
Katlego Ratau
Regards
Katlego Ratau
Bestmed Medical Scheme's reply18 May 2022, 13:29
Official
Hi Tshiamo,
we apologize for the inconvenience caused.
Kindly be informed that the invoice received is missing important information that is required to finalize the account.
Please note that communication was sent to the service provider on 06-May-22 and we are yet to receive feedback with an amended account containing all the required information.
In terms of the Medical Schemes Act and the Rules of Bestmed, a service provider must provide a medical scheme patient with a fully specified tax invoice within 30 days of a service being rendered. The tax invoice must contain – amongst others – at least the following information:
we apologize for the inconvenience caused.
Kindly be informed that the invoice received is missing important information that is required to finalize the account.
Please note that communication was sent to the service provider on 06-May-22 and we are yet to receive feedback with an amended account containing all the required information.
In terms of the Medical Schemes Act and the Rules of Bestmed, a service provider must provide a medical scheme patient with a fully specified tax invoice within 30 days of a service being rendered. The tax invoice must contain – amongst others – at least the following information:
(a) The surname and initials of the member;
(b) The first name and other initials, if any, and the date of birth of the patient;
(c) The name of the Scheme;
(d) The membership number;
(e) The practice number, name, and address of the supplier of service;
(f) The date on which each service was rendered;
(g) The relevant diagnostic (ICD 10 code) and such other item code numbers that relate to such services;
(h) The nature and cost of each relevant health service rendered, including the supply of medicine to the member concerned or to a dependant of that member; and the name, NAPPI code, quantity and dosage of, and net amount charged by the service provider in respect of the medicine;
(i) Where a pharmacist supplies medicine according to a prescription to a member or to a dependant of a member of a the Scheme, a copy of the original prescription or a certified copy of such prescription if the Scheme requires it;
You are kindly requested to obtain the fully specified tax invoice from the service provider and to resubmit the claim to Bestmed.
Regards
Katlego Ratau
Regards
Katlego Ratau