****AF refusing to pay claims coming from their own Network doctor!

On the 14th of October I went to consult at Medicross Meldene and I saw Dr WA Korras who is a Network doctor.He gave me a referral note to go see a specialist.

CAMAF approved the claim coming from Dr Korras.

On the 17th of October I went see a specialist and I submitted the referral letter that Dr Korras gave me but to my shock CAMAF REJECTED THE REFERRAL LETTER COMING FROM NETWORK DOCTOR, DR KORRAS, saying that this doctor is NOT a network doctor.

I queried CAMAF and they said they don’t recognise the practise number that the doctor wrote on my referral letter .I went back to the Doctor and asked that he put the practise number that CAMAF requires. My doctor was upset and he told me what CAMAF is telling me is not correct as he is a CAMAF network doctor.He called CAMAF to explain that he is a CAMAF network doctor and CAMAF still told him that they don’t recognise his practise number and they told him to give me another referral letter.The doctor scratched out the Practise number that CAMAF says they don’t recognise and he wrote the one that they wanted and he stamped the referral letter.

I sent the revised referral letter and CAMAF came back to me saying they still will not accept the revised referral letter and I should ask the doctor for another one! CLAIM STILL REJECTED WITH THE REVISED PRACTISE NUMBER THAT THEY REQUIRED!

The doctor explained to me that he falls under a group of Doctors called Dr Korras WA and associates that Dr Korras and Associates has a practise number but all the doctors that fall under Korras and associates have their own practise numbers and CAMAF should know this!He explained to me that CAMAF should have written his practise number on the website instead of the Groups practise number because I am now made to pay for CAMAF’s incompetence’s.

How is it possible that CAMAF approved the claim coming from Dr Korras but they now refusing to pay the specialist?I have given them a revised referral letter from this Network doctor but they still refuse to pay the claim!I do not appreciate the runaround that CAMAF is giving me!

You have upset me as your client and have now also upset your own network doctor by telling him that he is not a network doctor when he is infact a network doctor. It was not my first time going to this doctor and you have always approved my claims! But now that I have to go see a specialist you tell me that this doctor is not a network doctor.

CAMAF better fix their own mess!