Incompitent scheme

<p>Here we go again.</p> <p> </p> <p>Another bad review in a space less than a month. Its like this scheme loves the bad attention.</p> <p> </p> <p>On the 22 May the scheme approved my daughters PMB medication to 150ml for the month of May. On the 23 May 2017 our normal pharmacy did not get any stock of the drug called lanoxin paediatric elixer. lucky to find that melomed hospital pharmacy had in stock but expires on the 31/05/2017 so we took the 50ml. Just to give you a little backround on this drug. It is a hard to find drug that is necessary for my daughters condition.</p> <p> </p> <p>Now on tthe 26/05/2017 we found that christiaan barnard pharmacy has in stock. After trying to put through the medication twice you have rejected it saying the it is over the quantity.</p> <p> </p> <p>Calling in to your call centre is the worst. The agent advised the claim rejected for the above but your team leader advised its rejected due to DSP. Your own DSP does dont even have this medication how can you get it from the DSP if they dont have it and why is it now a problem with DSP if i have been getting it from different pharmacyies in the past. Then advising the member it will take till month to have the claim reprocessed. reference number : 260517Q98f3L. I will be taking this to coucil of medical scheme for failing to provide pmb medication.</p> <p> </p> <p>Another problem that i am having is the wellness extender benefit. Due to my daughters condition you would see her medical needs are extensive. Call through to 3 different agent on 3 different day to ask if there is any age limit for the wellness check. answer by 3 agents and a team leader Ndumiso no there is not. After going to the pharmacy to do the wellness on my daught to fine out they do not have the right equpment to do the wellness check. The blood pressure cuff is too big and they are unable to put N/A in the field, This is also your DSP provider. This was then escalated to a fund manager which advised there is a age of of 12 and olde. Please tell me where it says this on the benefit brocher and why 3 agent and a team leader does not know this.</p> <p> </p> <p>When will this scheme get its act together and stop wasting members time and money. Maybe the reason why you were under cuatorship because your system is incapable of process medical claims correctly. Maybe its time to jump ship before the scheme comes crashing down</p> <p> </p> <p>Regards</p> <p>Wayne</p>