Hellopeter
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MK
Megan K

1 reviews | Active since Jun 2023

22 Jun 2023, 08:48

WORSTMED

I zero stars were an obtion, that I what I would give this medical scheme. I have been with GEMS and Discovery in the past, but recently went over to my partners medical aid - BestMed. Communication is appauling. I have been awaiting authorization on a procedure for almost a month now, sent from pillar to post. Claims are even worse. I had two claims from the same specialist, they paid one and refused to pay the other, unit I called and questioned the process. I don't even want to talk about paying out the claim. NO ONE seems to know what the other is doing. I emailed their Executive Corporate Relations person, no response. Escalated the matter still no response. Elmerie Jooste the Corporate relations executive has a cellphone number listed, no response to this either. I am perplexed, disgusted and exhausted dealing with WORSTMED!

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Replies (8)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply22 Jun 2023, 14:40
Official
Dear Megan Kayser
 
We are sincerely sorry to hear about your experience with our service to you. 

Kindly be informed that regarding pending authorisation, feedback was emailed to you this morning.

Claims have been processed and are due for payment. However, we did not have the banking details to refund the claims. The banking details were loaded today after we received them on 21/06/2023. 

Payment will be made on our next payment run, which is on 27/06/2023.
 
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. 

Regards 
Nondumiso Letsoalo
MK
Megan K's update22 Jun 2023, 14:43
Reviewer Update
Hi Nodumiso

I am still getting back and forth regarding my authorization, the email stated nothing actually
Bestmed Medical Scheme
Bestmed Medical Scheme's reply22 Jun 2023, 15:08
Official
Dear Megan

The request is with the clinical advisory committee for an urgent review, and as soon as it's finalised, we will provide you with feedback. 

Regards
Nondumiso Letsoalo

MK
Megan K's update23 Jun 2023, 08:27
Reviewer Update
The day of my sugery and still nothing. I am not very surprised. This is not going to be the end of it, it is now the second date I am missing. My initial date was 9 June, it is now 23 June and no concise reasoning behind the delay can be given. This is appaulling service, we pay so much money to be on this medical aid and the service is so poor. I work in a service industry too. If this sort of thing happened in our company, someone was going to be held accountable. I am too a manager and I am very aware of turnaround times, policies and procedures etc. However we pride ourselves in being customer centric, our customers really comes first. Best Med in no way is putting the needs of its clients first. This operation is life changing for me, I have a 7 month old baby who I am unable to hold and take care of properly due to the pain in my left hand. The simple surgery that I have been seeking authorization for since 2 June can alter how I go about my day to day life. Humaness is lacking in this business.
Bestmed Medical Scheme
Bestmed Medical Scheme's reply23 Jun 2023, 09:09
Official
Dear Megan Kayser

As you may recall from your recent call with one of our consultants, the case is currently in its investigation phase. This is an essential step in our authorisation process, where we thoroughly review all the relevant details to ensure we reach an accurate decision.

We understand how critical this authorisation is for you, and we appreciate your patience during this process. We are making every effort to expedite the investigation, and once all necessary investigations are completed, you will be immediately informed of the outcome.
 
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. 

Regards
Nondumiso Letsoalo
MK
Megan K's update23 Jun 2023, 12:35
Reviewer Update
As you rightfully said a consultant called me yesterday, just to reitterate the same "nothing" I've been told before. She called me again minutes ago to say the same nothing. As I mentioned before, I am also in a service industry, the only diffence is I am client facing, so I can't hide behind emails and turnaround times. If a customer is shouting in the lobby or at reception, I go out and deal with it, as it should,because the aim is not to have dissatisfied clients. I am a very dissastified client, and HELLOPETER is now my lobby because the endless emails and calls has just frustrated me more. " Your case is with the membership department". Then I call the membership department only to be transfered back to authorizations department. My case is now with Dr H investigating. Who is this Dr and why can nobody flag this case as URGENT. This is probably above the pay grade of the person politely responding to my reviews, hence the lack of following up. THIS CASE NEED TO BE FLAGGED ASAP. I really don't see the reason for this lengthy investigation, all documentation has been submitted
Bestmed Medical Scheme
Bestmed Medical Scheme's reply23 Jun 2023, 13:19
Official
Dear Magan,

I am very sorry about your experience regarding our service.

The case has been escalated to Management for urgent assistance with finalization and feedback to you.
 
Your wellbeing, as a valued client of the Scheme, is important to all of us at Bestmed. 

Regards
Katlego Sithole


MK
Megan K's update26 Jun 2023, 07:53
Reviewer Update
Here we are, still waiting.