I HAVE NO WORDS TO DESCRIBED THIS SCHEME

<p>SO I WENT TO COLLECT MY GRANDMOTHER MEDICATION FRO M THE PHARMACY HER CLOPIWIN PLUS TABLETS WERE REJECTED ON THE THE ERROR CODE OF BENEFIT LIMITS AND OR SAVINGS HAS BEEN USED UP. I KNOW THIS MEDICATION OS NOT A PMB LEVEL TREATMENT THUS THE SCHEME HAS APPROVED THE DRUG FROM PMB BENEFITS FOR 6 MONTHS THIS APRIL WAS THE LAST MONTH. WHEN I CALLED THE SCHEME THE CHRONIC DEPARTMENT TASNEEM ASSURED ME THE DRUG IS LOADED AND SUPPOSED TO PAY ACCRODINGLY SHE ADVISED THAT I SPEAK TO THE SCHEMES CLAIMS DEPARTMENT. SO I PROCEED AND HIS EXPLAINATION IS THAT THE MEDICATION WAS AN EARLY FILL WHICH IS BULL**** WHY BECAUSE FROM VARIOUS YEARS OF EXPERIENCE THAT WHOULD BE THE CODE WHEN THE PHARMACY SUBMITTED IN THE FIRST PLACE. NOW I AM ASKING THE SCHEME WHAT SHOULD WE DO. WE ARE ENTITLED TO THIS MEDICATION BEING THE LAST MONTH. THIS ONCE AGAIN REFLECTS THE ILL EQUIPED CONSULTANTS THAT THE SCHEME ENTERTAINS. FURTHER MORE THE CONSULTANT WANT ME TO TELL THE PHARMACY TO REVERSE THE CLAIM AT INTERPHARM WHY MUST THEY REVERSE IT IF I NEVER TOOK THE MEDICATION HOME AND THE PARMACIST REVERSED THE CLAIMED AFTER IT REJECTED.</p> <p> </p> <p>SECONDLY THE SCHEME IS INVESTIGATING A COMPLAINT OF CLIAMS RELATEING TO LANCET LABS THIS IS ONGOING FOR THE PAST 3 WEEKS IN THE MEAN TIME THE SEND ME LOUSY EMAILS STATING THAT THE ARE STILL INVESTIGATING NO PROGRESS UPDATES. THUS ON THE OTHER SIDE LANCET IS PERSUEING DEBT COLLECTION METHODS AGAINST MY GRAND MOTHER WHO IS ILL FOR ACCOUNTS THAT SHOULD HAVE BE SETTLED BY THE SCHEME. </p> <p>IT AMAZE ME HOW MUCH ADMIN THE MEMBER HAS TO DO FOR THE SCHEME TO DO THERE WORK ACCORDING LY.</p> <p> </p> <p>THIRDLY A VERY SENSITIVE ISSUE THAT THE SCHEME IS AVOIDING THE ORTHODONTIC REQUEST TO DEPENDENT 01 HAS BEEN DECLINED. BASED ON AGE RELATED ISSUES. AGAIN THE SCHEME DOES NOT WANT TO ACKNOWLEDGE THE FACT THE THE MEDIPLUS OPTION BROCHURE FOR 2017 DID NOT INDICATE THE AGE FACTOR THIS AFFTER MANY OTHER SCHEMES OF WHICH I FURNISHED PROOF TO THE THE SCHEME HAS INDICATED THIS ON THERE BROCHURE. AS A MEMBER THAT OTHER MEMBERS WILL AGREE THIS IS A DETERMINING FACTOR THAT WOULD INFLUNCE IF I DECIDE TO CHOOSE A SPECIFIC SCHEME OR NOT MEANING I COULD HAVE CHOOSEN ANOTHER SCHEME IF I NEW THIS INFORMATION ON INCEPTION. </p> <p> </p> <p>NOW I HAVE PLEADED WITH THE SCHEME TO ATLEAST PAY THE FIRST YEAR OF TREATMENT ONLY. THE MAIN MEMBER HAS AGREED TO FORGO THE OTHER BENEFITS THAT ARE COVERED UNDER SPECIALISED DENTISTRY. </p> <p>I HAVE SUBMITTED VARIOUS MOTIVATIONS AND APPEALS AND I ASK TO PLEASE REVIEW THE MATTER TOGETHER WITH THE CURRENT OUTSTANDING CLAIM FROM DR VOSTER. I WILL NOT REST UNTIL THE SCHEME HAS MET ME HALF WAY.</p> <p> </p> <p>FORTHLY THE ANNUAL SPECIALIST VISIT I WOULD LIKE TO KNOW THAT WHEN A SPECIALIST CLAIMS FOR THE FIRST TIME IN THE YEAR SHOULD IS NOT JUST GET PAID FROM THAT 1 SPECIALIST VISIT FOR THE FIRST TIME MUST IT ALSO BE BILLED TO THE DAY TO DAY ACCOUNTS. </p> <p>I KNOW THE TRADITIONAL PLAN STORY ALREADY I NEED CLEARITY. </p> <p> </p> <p>IT IS A PITY THAT THE AGM IS SO FAR HAD I BEEN GIVEN TRANSPORT I WOULD SURELY BE SITTING IN ON THAT MEETINGD. MEDSHIELD USES PROPOGANDA TO EXPALIN THERE BENEFIT GUDES AND LIMITS TO MEMBERS. LIKE THE CHRONIC AND NON CHRONIC MEDICATION BENEFIT THE DO NOT SAY THAT THE R1000 +- IS A COMBINED BENFIT THEY DO HOWEVER MENTION IT IN A VERY TINY TEXT FURTHER IN THE BROCHURE. THIS IS MANIPULATING TACTICS. </p> <p> </p> <p>I GUESS WE ARE BUL**** BY OUR SCHEME BECAUSE WE ARE POWERLESS INDEVIDULS WHOS MONEY TASTE GOOD. </p> <p> </p> <p>I PLEAD WITH MEDSIELD TO REALLY RECONSIDER THE ORTHODONTIC TREATMENT. </p> <p>AND RESOLVE ALL OTHER QUERIES. </p> <p> </p> <p> </p>