1 reviews | Active since May 2015
med aid aproved procedure which they wont pay for.
discovery med aid approved procedures for my wife at lenmed clinic Lenasia.<br> she was at the hospital for four days ,the doctor decided that she should go for gastroscopy .<br> I phoned my wife told her that she should confirm with med aid before any procedure is done on her<br> <br> when she asked she was told that the procedure was approved ,only to find out later that for that procedure to be done R3400 had to be paid upfront and the rest the mad aid will cover.<br> <br> no one notified either me as a policy holder or my wife about the short fall that will occur if that procedure is done, the discovery approved even when they knew the were not going to pay for that procedure ,because the were no funds in the savings account. now am faced with a bill and possible attorney letters soon.
Thank you for your comment.
I investigated your query and confirmed that when the clinic contacted us to approve the hospital admission. We can only make funding decisions based on the information provided. The hospital only notified us what treatment your spouse had after she was discharged. We could not have confirmed funding regarding this procedure before hand as we were not informed.
I have sent a detail email with further details of your query. We are awaiting additional information so we may continue to assist you with your query.
I do understand that you may not be satisfied with the outcome however it is in line with the Scheme rules.
Kind regards
Jashvir
Thank you for your comment.
I investigated your query and confirmed that when the clinic contacted us to approve the hospital admission. We can only make funding decisions based on the information provided. The hospital only notified us what treatment your spouse had after she was discharged. We could not have confirmed funding regarding this procedure before hand as we were not informed.
I have sent a detail email with further details of your query. We are awaiting additional information so we may continue to assist you with your query.
I do understand that you may not be satisfied with the outcome however it is in line with the Scheme rules.
Kind regards
Jashvir
