YM
Yatish M

1 reviews | Active since Aug 2018

06 Aug 2018, 20:02

SELFMED MEDICAL AID. A TOTAL *******

I have been paying for my mom's medical aid for over a year. She had never used the medical aid. When she does fall ill and really need to be in hospital to get treatment, they find every reason not to authorize hospital admission. From wrong codes to accusing us of not filling in the forms correctly. She has 3 conditions that fall within the Pmb but still no authorization. She spent an entire day waiting for admission only to be told that she needed more motivation from the doctor. Then get sent home as they close at 5pm. DO NOT EVER USE THIS MEDICAL AID. It's easy to take people's money but so very hard to give them the treatment they pay for. I did the stupid thing of also signing my dad onto this medical aid a year ago as well. AGAIN THIS IS NOT A MEDICAL AID THAT ONE SHOULD RELY ON.

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Replies (3)
Selfmed Medical Scheme
Selfmed Medical Scheme's reply08 Aug 2018, 07:48
Official

Dear Y Maharaj

Thank you for bringing this case under our attention and allowing the Scheme an opportunity to investigate your complaint. The Selfnet option provides hospital cover for PMB conditions. The Scheme can unfortunately not approve an admission if the diagnosis code supp**** by the provider is not a PMB condition.

The Scheme contacted the provider and requested additional information. On receipt of the additional information the authorisation was released.

An Expert from the Excellence Centre liaised with you on this matter.

We regret that you have not experienced the service we are renowned for and remain committed to providing excellent service to our members.

Regards,

SELFMED MEDICAL SCHEME

YM
Yatish M's update23 Apr 2019, 14:29
Reviewer Update
Not many people change their review once an issue has been resolved. I had to do so and commend SELFMED for the excellent service received once all paperwork was in order. they went beyond their call of duty to assist my mother in her final days. they were very accommodating and compassionate throughout the entire illness. My mom sadly passed away on the 04 April 2019. SELFMED assisted us in every way possible and when they could. Their oncology department was very helpful as well. Thank you guys and GOD BLESS...
Selfmed Medical Scheme
Selfmed Medical Scheme's reply23 Apr 2019, 15:24
Official
Dear Yatish M

Our deepest condolences for your loss. Our thoughts are with you during this difficult time.

Thank you for taking the time to post the compliment. Selfmed strives to deliver excellent services to all our members.

Regards,

SELFMED MEDICAL SCHEME