Disappointed
<p>If you are on the Network option and happen to have a bladder infection dont even bother going to the Doctor because CAMAF does not pay for the prescribed medication. I really have no idea what's the point of this medical aid because you really dont want to pay for anything unless one has flu. I went to the Doctor about a month ago and that amount still has not been settled, who is supposed to settle it? I pay so much money for this medical aid and right now I think it would be wiser for me to just flush that money down the drain because clearly I am already doing that. You are happy to collect our money but when the time to pay comes there is no excuse in the book you dont come up with. What exactly do you pay for? Flu meds only?</p>
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Camaf's replyOfficial
19 Sept 2016, 14:37Dear Nosipho
Thank you for taking my calls earlier.
As discussed, the claims for Dr Hansraj & Associates have been processed as follows:
- 1) 26/08/2016 - this claim was paid to the service provider on the claims statement dated the 03/09/2016. I have re-emailed a copy of this statement to you.
- 2) 17/09/2016 - this claim has been processed & will be paid to the service provider in this week's payment run. Once the payment has gone through, a claims statement will be emailed to you.
As discussed, the medication the doctor prescribed is not on the CAMAF medication formulary for members on our Network Choice option. The doctor must prescribe medication which form part of the formulary as medication not on the formulary is not covered by the Scheme.
Should you have any further questions or concerns, please do not hesitate to contact me.
Kind Regards,
Caleb Brownley
Client Relations Supervisor
Best regards,
Camaf's reply19 Sept 2016, 14:37
Official
Dear Nosipho
Thank you for taking my calls earlier.
As discussed, the claims for Dr Hansraj & Associates have been processed as follows:
- 1) 26/08/2016 - this claim was paid to the service provider on the claims statement dated the 03/09/2016. I have re-emailed a copy of this statement to you.
- 2) 17/09/2016 - this claim has been processed & will be paid to the service provider in this week's payment run. Once the payment has gone through, a claims statement will be emailed to you.
As discussed, the medication the doctor prescribed is not on the CAMAF medication formulary for members on our Network Choice option. The doctor must prescribe medication which form part of the formulary as medication not on the formulary is not covered by the Scheme.
Should you have any further questions or concerns, please do not hesitate to contact me.
Kind Regards,
Caleb Brownley
Client Relations Supervisor
Best regards,