Worstmed not Bestmend
Not BESTmed, WORSTmed!!! First of all i was mislead by a consultant (with evidence of our conversation) that i can visit the optometrist. went did the eyestest when it came to claiming, i was advised i have no benefits, i had to pay out of my own pocket R499. after enquiring at bestmed they said, i must send a email explaining the problem to ***. i sent the email and haven't heard back ever since its almost 3 weeks now!! PATHETIC!! cant admit when they make a mistake, and costs me money. i am currently 30 weeks pregnant. i need to get RH injection. Its not a choice, having a negative blood group, without the injection i would need 2 blood transfusions with the birth and baby would need to go to nicu. how cant you pay for such an important injection? how can you think that it is better to pay for R300 000 hospital costs is better than paying R500 for an injection??? and putting my own and my child's life in danger. with my 2 previous pregnancies i had the same injections with Profmed and Momentum and they covered it!! this is pathetic!!!
Helpful (0)
Replies (5)0
Replies (5)
Bestmed Medical Scheme's replyOfficial
22 Jan 2024, 13:00Dear Alida
Please note that your complaint regarding the confirmation of optical benefits has been escalated to our quality control supervisor for further investigation. Once the investigation is completed, we will provide you with feedback.
Additionally, I wanted to inform you that the request for the iron deficiency injection was declined, as the iron levels were within the range.
Regards
Nondumiso
Please note that your complaint regarding the confirmation of optical benefits has been escalated to our quality control supervisor for further investigation. Once the investigation is completed, we will provide you with feedback.
Additionally, I wanted to inform you that the request for the iron deficiency injection was declined, as the iron levels were within the range.
Regards
Nondumiso
Bestmed Medical Scheme's reply22 Jan 2024, 13:00
Official
Dear Alida
Please note that your complaint regarding the confirmation of optical benefits has been escalated to our quality control supervisor for further investigation. Once the investigation is completed, we will provide you with feedback.
Additionally, I wanted to inform you that the request for the iron deficiency injection was declined, as the iron levels were within the range.
Regards
Nondumiso
Please note that your complaint regarding the confirmation of optical benefits has been escalated to our quality control supervisor for further investigation. Once the investigation is completed, we will provide you with feedback.
Additionally, I wanted to inform you that the request for the iron deficiency injection was declined, as the iron levels were within the range.
Regards
Nondumiso
's updateReviewer Update
22 Jan 2024, 13:12OH my soul, you work for a medical aid and you don't even know what RH-factor is... let me explain to you, it has NOTHING to do with iron deficiency... oh my goodness, If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
BESTMED GET INFORMED PEOPLE TO ANSWER PROBLEMS!!!
BESTMED GET INFORMED PEOPLE TO ANSWER PROBLEMS!!!
's update22 Jan 2024, 13:12
Reviewer Update
OH my soul, you work for a medical aid and you don't even know what RH-factor is... let me explain to you, it has NOTHING to do with iron deficiency... oh my goodness, If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
BESTMED GET INFORMED PEOPLE TO ANSWER PROBLEMS!!!
BESTMED GET INFORMED PEOPLE TO ANSWER PROBLEMS!!!
Bestmed Medical Scheme's replyOfficial
23 Jan 2024, 12:05Dear Alida
I sincerely apologize for any confusion resulting from the oversight in our previous communication. Upon reflection, I now realize that I misunderstood the specifics of your inquiry about RH injections and incorrectly assumed the application was related to Cosmofer.
Regarding the payment of R9.44 for Rhesugam, please be aware that it was covered from available vested savings (carried-over savings) due to its exclusion from the formulary list for supplements and vitamins.
I have emailed you the necessary form to facilitate the RH injection application process. Please have your doctor complete the form and submit it, along with the prescription, to *** for review.
Regards
Nondumiso
I sincerely apologize for any confusion resulting from the oversight in our previous communication. Upon reflection, I now realize that I misunderstood the specifics of your inquiry about RH injections and incorrectly assumed the application was related to Cosmofer.
Regarding the payment of R9.44 for Rhesugam, please be aware that it was covered from available vested savings (carried-over savings) due to its exclusion from the formulary list for supplements and vitamins.
I have emailed you the necessary form to facilitate the RH injection application process. Please have your doctor complete the form and submit it, along with the prescription, to *** for review.
Regards
Nondumiso
Bestmed Medical Scheme's reply23 Jan 2024, 12:05
Official
Dear Alida
I sincerely apologize for any confusion resulting from the oversight in our previous communication. Upon reflection, I now realize that I misunderstood the specifics of your inquiry about RH injections and incorrectly assumed the application was related to Cosmofer.
Regarding the payment of R9.44 for Rhesugam, please be aware that it was covered from available vested savings (carried-over savings) due to its exclusion from the formulary list for supplements and vitamins.
I have emailed you the necessary form to facilitate the RH injection application process. Please have your doctor complete the form and submit it, along with the prescription, to *** for review.
Regards
Nondumiso
I sincerely apologize for any confusion resulting from the oversight in our previous communication. Upon reflection, I now realize that I misunderstood the specifics of your inquiry about RH injections and incorrectly assumed the application was related to Cosmofer.
Regarding the payment of R9.44 for Rhesugam, please be aware that it was covered from available vested savings (carried-over savings) due to its exclusion from the formulary list for supplements and vitamins.
I have emailed you the necessary form to facilitate the RH injection application process. Please have your doctor complete the form and submit it, along with the prescription, to *** for review.
Regards
Nondumiso
's updateReviewer Update
23 Jan 2024, 15:22Sjoe Nondumiso, I received the chronic medication form you sent me.... RH incompatibility is not a disease.... i only need 2- 1 pre labour injection and 1 post-delivery. I do not need permanent medical treatment. I do not know how to explain it to you other than like i already did.... carefully read the info below again....
If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
's update23 Jan 2024, 15:22
Reviewer Update
Sjoe Nondumiso, I received the chronic medication form you sent me.... RH incompatibility is not a disease.... i only need 2- 1 pre labour injection and 1 post-delivery. I do not need permanent medical treatment. I do not know how to explain it to you other than like i already did.... carefully read the info below again....
If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get: the first shot around the 28th week of pregnancy. the second shot within 72 hours of giving birth. And if you still sitting puzzled about what RH factor is.... The Rh factor is one of the proteins on RBCs used to indicate whether the blood of two different people is compatible when mixed – such as blood of a mother and her baby at birth. It is routine and important that the Rh factor for a mother and unborn child be determined during pregnancy.
Bestmed Medical Scheme's replyOfficial
23 Jan 2024, 15:51Dear Alida
Please be informed that completing the form is in accordance with scheme protocols to facilitate a seamless assessment and authorization of the medication. Providing the necessary information ensures that claims can be processed effortlessly and from the correct benefit. We are aware that it is not a chronic.
Nevertheless, I have spoken with our Medicine Department, and you can submit the prescription along with the ICD-10 code indicated on it.
Regards
Nondumiso
Please be informed that completing the form is in accordance with scheme protocols to facilitate a seamless assessment and authorization of the medication. Providing the necessary information ensures that claims can be processed effortlessly and from the correct benefit. We are aware that it is not a chronic.
Nevertheless, I have spoken with our Medicine Department, and you can submit the prescription along with the ICD-10 code indicated on it.
Regards
Nondumiso
Bestmed Medical Scheme's reply23 Jan 2024, 15:51
Official
Dear Alida
Please be informed that completing the form is in accordance with scheme protocols to facilitate a seamless assessment and authorization of the medication. Providing the necessary information ensures that claims can be processed effortlessly and from the correct benefit. We are aware that it is not a chronic.
Nevertheless, I have spoken with our Medicine Department, and you can submit the prescription along with the ICD-10 code indicated on it.
Regards
Nondumiso
Please be informed that completing the form is in accordance with scheme protocols to facilitate a seamless assessment and authorization of the medication. Providing the necessary information ensures that claims can be processed effortlessly and from the correct benefit. We are aware that it is not a chronic.
Nevertheless, I have spoken with our Medicine Department, and you can submit the prescription along with the ICD-10 code indicated on it.
Regards
Nondumiso