UP TO **** MEDICAL AID

I HAVE NO WORDS TO DESCRIBE THIS PATHETIC MEDICAL AID MY GRAND MOTHER HAS LAB TESTS DONE AND VSITED THE CARDIOLOGIST. SHE IS REGISTERED FOR ALL THE HEART CONDITION AND VISITED THE SAME SPECIALIST WHO PERFORMED PREVIOUS PROCEDURES. THE CLAIMS WHERE SUBMITTED AND RETURN WITH REJECTION CODE 514 NO FUNDS THIS PRODURES WERE CLEARLY FOR CHRONIC CONDITIONS AND NOT FOR FUN. THE PROBLEM IS THE MEDICAL AID GIVES THE PATIENT A MANAGED CARE LIST AT THE END OF EVERY MONTHLY STATEMENT.

YET THEY DO NOT SPECIFY WHAT PROCURES ARE FOR WHAT CONDITION IT SEEMS AS IF THE PATIENT MUST SIFF IT OUT. MEMBERS CANNOT REGULATE DRS BILLING PRACTICES AND THUS CANNOT FORCE BILLING CODES ON THE DOCTOR I NEED MEDSHIELD TO INVESTIGATE THIS AS HER CONSULTATION WAS FOR A PMB CONDITION AND THUS PMB LEVEL OF CARE FUNDING MUST BE ALLOCATED.

SECONDLY BACK IN 2017 WE HAD A ISSUE WITH THE STATIN MEDICATION FOR CHOLESTEROL DR PRISCRIBED 10MG ROSTOR AND SCHEME DID NOT WANT TO FUND WAS TOLD THAT MEMBER MUST CONTINUE WITH 5MG AND VIEW RESULTS LATER THUS ON THE VERY SAME DAY AT THE CARDIOLOGIST. HER LIPOGRAM WAS VER ABNORML AND DR PRICRIBED 10 ROVATOR AGAIN. I WOULD LIKE TO REMIND THE CHRONIC DEPARTMENT TO LOOK BACK ON THERE NOTES AND ADVISE WHAT SHOULD BE DONE AS THEY DID SAY OF THE REQUIRED LEVELS ARE NOT MET THEY WILL COSIDER FUNDING

LAST LT DO NOT DARE TELL ME ABOUT A TRADITIONAL AND NEW GENERATIONAL PLAN PMB SHOULD BE FUNDED ACCORDINGLY.

MY MOTHER ON A NOTHER MEDICAL AID VISITED THE SAME DR AND WAS TREATED FOR THE SAME CONDITION SAME CODES AND IT WAS PAID IN FULL CLEARLY INDICATING PMB CARE FUNDING.

MEDSHIELDS HIGH PREMIUM INCREASES SURELY DOES NOT LOOK AFTER THE MEMBER.

**** I HAD IT WITH ICD 10 CODES NAPPI CODES PMB CODES AND BACKLASH FROM THE THE SCHEME ACT OUT YOUR SLOGAN GET MEDICAL PAID FOR ONCE.