SM
Stephanie M

1 reviews | Active since Dec 2015

02 Dec 2015, 18:22

Poor service for claims

I'm a Topmed member and I had a wisdom tooth exclusion for one year. So as soon as my year was up I made the appointment to have them removed and so began my procedure. I made the Necessary arrangements and all that was needed was the authorisation . 2 weeks before I have to go in, I phoned asked what was needed and sent it through. No reply, called again, was asked for more recent x-rays and sent it through, again no reply. Phoned again they were sending it to the dentist for authorisation and would send word the next day, again nothing. Phoned again spoke to a man named Justin, he said my exclusion only ended the following year, which was wrong as I had checked this before making the appointments. Mailed through my details again with the email confirming my exclusion was over. No reply so I phoned again and apparently they haven't received my x-rays, so I mailed it again and still I'm waiting. My appointed date is in 1 days time and it's taking them two weeks to give authorisation. I was told it could be done in a day if not less and I'm stuck in a situation where I'm in constant pain and stressed out over whether or not I will have to pay for this on my own.

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Replies (1)
TopMed Medical Scheme
TopMed Medical Scheme's reply03 Dec 2015, 11:15
Official
Hello Stephymay2719,

I have tried contacting you on the number you have provided, there was no answer, i did leave a voice message for you.

I apologise for being given the wrong information with regards to your exclusion and can assure that this will be addressed with the agent.

Upon further investigation, i see that your authorisation was released this morning. i will try to contact you again during the course of the day to give you your authorisation details. In normal circumstances a authorisation of this sort can be approved within 24-48hrs if the all required documentation is received, the reason your authorisation took longer than usual is because we were waiting for your x-ray report which we received on the 30th of November.

Kind regards,
Chanele Schoonraad