IL
Ivan L
1 reviews | Active since Apr 2014
14 Oct 2015, 15:57
Refusal to pay claim
I phone a representative at Camaf to confirm that I can buy a breast pump on their list and claim it back. Nothing was mentioned as to where I must bay the breast pump.<br> After I bought the breast pump, I was told it must be at a pharmacy. Now I must take back the breast pump which my wife got on a special and buy the same breast pump from a pharmacy at increase cost of over a 1000 rand.<br> <br> This make no economical sense. <br> <br> How can I recommend after shuts a bad financial rule the medical scheme to anyone.<br> No wonder the government want to implement a national medical aid and get rid of medical scheme.<br>
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Camaf's replyOfficial
14 Oct 2015, 17:11Hello Witbliz,
In order for any claim to be honoured by a medical scheme, the service must be rendered by valid practice registered by with the Board of health care funders (BHF) and that includes purchases of appliances. Although a retail store may charge less for an item, the scheme is unable to process such claims as they will not provide the information required to process a claim and do not have a practice number.
Communication of this information is re-iterated in the welcome letter sent out to all members when they register on the mother to be programme.
We do apologise for the inconvenience caused in this regard.
Yours sincerely.
Boniswa Mbuwako
Supervisor: Client relations
In order for any claim to be honoured by a medical scheme, the service must be rendered by valid practice registered by with the Board of health care funders (BHF) and that includes purchases of appliances. Although a retail store may charge less for an item, the scheme is unable to process such claims as they will not provide the information required to process a claim and do not have a practice number.
Communication of this information is re-iterated in the welcome letter sent out to all members when they register on the mother to be programme.
We do apologise for the inconvenience caused in this regard.
Yours sincerely.
Boniswa Mbuwako
Supervisor: Client relations
Camaf's reply14 Oct 2015, 17:11
Official
Hello Witbliz,
In order for any claim to be honoured by a medical scheme, the service must be rendered by valid practice registered by with the Board of health care funders (BHF) and that includes purchases of appliances. Although a retail store may charge less for an item, the scheme is unable to process such claims as they will not provide the information required to process a claim and do not have a practice number.
Communication of this information is re-iterated in the welcome letter sent out to all members when they register on the mother to be programme.
We do apologise for the inconvenience caused in this regard.
Yours sincerely.
Boniswa Mbuwako
Supervisor: Client relations
In order for any claim to be honoured by a medical scheme, the service must be rendered by valid practice registered by with the Board of health care funders (BHF) and that includes purchases of appliances. Although a retail store may charge less for an item, the scheme is unable to process such claims as they will not provide the information required to process a claim and do not have a practice number.
Communication of this information is re-iterated in the welcome letter sent out to all members when they register on the mother to be programme.
We do apologise for the inconvenience caused in this regard.
Yours sincerely.
Boniswa Mbuwako
Supervisor: Client relations