TM
Tim M

1 reviews | Active since Aug 2012

29 Jan 2016, 16:14

Look for another provider before considering Camaf

Long story short, we took our son to hospital because of high fever.<br> We had 1 casualty claim for treatment which was supposed to be covered at this hospital.<br> The hospital confirmed that they do accept Camaf and directed us to the CASUALTY EMERGENCY WARD.<br> He was treated by nurses and doctor.A few weeks later we received a bill for the treatment.<br> We contacted CAMAF and they responded that this was a GP visit and since we've used allocated visits they would not pay. A few to and fro mails/calls trying to get an explanation(more like casual responses) from CAMAF came to them blaming the hospital for not explaining to us that the casualty ward is actually considered a GP visit and that we should've contact them to understand the difference between casualty and GP.<br> Few Notes:<br> -Expect to hold and be cut-off on calls, bottom of the barrel quality.<br> -Responses sound like they're being read from the brochure, SENIOR consultants contact you without getting context on the problem. Basically, you'll have to repeat the story. No sense that you're a valued client.<br> -Prepare to be the one to follow up on your queries i.e. you'll have to chase them.<br> -Shop around if possible, there's better out there.

0
Replies (1)
Camaf
Camaf's reply01 Feb 2016, 15:20
Official
Hello timo06,

The Network Choice option elected by the Principal member primarily caters for treatment at a network doctor.

However this option also caters for one emergency visit at a non-network doctor or casualty per beneficiary. This information was communicated to the Principal member on more than one occasion.

We note that the person logging this complaint is not a member nor a beneficiary of CAMAF. We consider this matter closed and will engage the principal member further on this.

Yours Sincerely,
Tertia Louw
CAMAF
Client Relations Supervisor