1 reviews | Active since Dec 2014
Deduction from 2013 in 2015!!
Please note i'm no longer a active member on this scheme (thank goodness)<br> I've submitted a claim to Topmed for a procedure done for my dependent in Nov 2015.<br> Topmed confirmed that they have processed and paid x-amount into my account, but when the funds reached my account it was less, with further investigation it came to light that they have deducted an overpayment amount THEY'VE made to a supplier in **2013** !!!!! Two years later.<br> With each and every claim I've only had the utmost of difficulty to get feedback from them, mistakes and misconduct on their part, or in most parts no reply at all.<br> A while back they even refused to pay an account when the same dependent was admitted to hospital with a life threatening virus (RSV virus) - i have all the mails and voice recordings still on file.<br> Time to contact the Financial Services Board and report them.<br> If anybody is considering joining this scheme -- coming from a person working in the financial industry ...run..run..run like i did and joined a more reputable medical scheme.
According to our records monthly statements were issued to you confirming that an amount was due to the Scheme as a result of an overpayment made to you for a doctor's claim. The first statement indicating this, was dated the 01/09/2013. Debt is offset against the first payment that is due to you.
The admission for the RSV virus was not declined and payment was made in respect of that admission. The dispute was that the treating doctors were charging above the Scheme rate and the claims were only paid at the Scheme rate. The dispute was resolved and TopMed agreed to pay all treating doctors in full after reviewing the clinical information provided to us.
TopMed Medical Scheme is committed to providing our members with the best service possible. We agree that there will be disputes and hence we a have process in place to ensure all disputes are dealt with timeously.
We thank you for your input as we value all our members input to ensure we can improve our service delivery going forward.
Kind regards
Yolandi Knoetze
According to our records monthly statements were issued to you confirming that an amount was due to the Scheme as a result of an overpayment made to you for a doctor's claim. The first statement indicating this, was dated the 01/09/2013. Debt is offset against the first payment that is due to you.
The admission for the RSV virus was not declined and payment was made in respect of that admission. The dispute was that the treating doctors were charging above the Scheme rate and the claims were only paid at the Scheme rate. The dispute was resolved and TopMed agreed to pay all treating doctors in full after reviewing the clinical information provided to us.
TopMed Medical Scheme is committed to providing our members with the best service possible. We agree that there will be disputes and hence we a have process in place to ensure all disputes are dealt with timeously.
We thank you for your input as we value all our members input to ensure we can improve our service delivery going forward.
Kind regards
Yolandi Knoetze