ProfMed Cumbersome and Inefficient Claims Process

After being a claim free member of this medical aid scheme for 22 years, I now find that I have had to submit some significant claims.

There are no guidelines to the claims processes for their various departments, the claims I have had to make have resulted in a plethora of claims reference numbers and at a time when I feel under stress, they submit my claims to a clinical audit process for which I received unclear correspondence from more than one source so I am really confused as to what the due process is.

Having finally gotten through to someone who is processing the claims, and despite my instructions on the body of the emails, and on the invoices, to reimburse me directly as I have already had to pay service providers, this person has set up payment runs to the service providers. So potentially I would have to untangle that as well if the payment run goes through.

Since this person does not respond to emails, even to acknowledge receipt, and has no telephone number indicated on the mails I am powerless to do anything about it. Profmed claims to provide "Intelligent Benefits" for professionals, so I think it is about time they apply some intelligent training to their staff, and take a serious look at their overly cumbersome system

They seem more pre-occupied with changing the name of their benefit offerings than anything else. My own benefit option is now in it's 3rd name change in the last few years. If they think that this will keep them up with the competition, they must rethink their strategy!