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Leila G

1 reviews | Active since Sept 2018

06 Sept 2018, 16:33

STAY AWAY FROM TOPMED

Hi,

While on leave the 6th of July I went to hospital with an emergency, feeling very bad. I had no waiting period on my medical aid so I thought it will be fine. The ER decided that it will be better to admit me to hospital.

When the hospital tried to get authorization, they said they want to investigate to see if I have any pre-existing conditions (and I did not have a pre-existing condition).

Now its 6 September and this investigation should have only taken up to 14 working days.

The hospital, Doctor and pathologists is getting impatient and the case worker comes up with a bull**** story to prolong the process every other day.

I do not know what to do. It feels like they will get me financially in trouble, because the hospital only gives me 3 months to pay and I cant.

What must I do, must I sue them or what?

0
Replies (3)
TopMed Medical Scheme
TopMed Medical Scheme's reply06 Sept 2018, 16:43
Official

Dear ***

As per our telephonic discussion, we will investigate the matter and provide feedback to you directly.

Kind regards

Joanine Knoetze

LG
Leila G's update15 Sept 2018, 08:22
Reviewer Update
Hi, According to the caseworker the board wants more info. They want something that is not there and it still feels like they just trying to prolong the process. I am getting really fed-up!!! I was with sizwe medical fund before I joined Topmed and had full access to hospital, specialists, JP's and everything. Do you really think I would leave that if something was wrong with me in the 1st place!!!! I do not have to explain myself anymore. This must be sorted by Monday or I will start making arrangements to sue!
TopMed Medical Scheme
TopMed Medical Scheme's reply17 Sept 2018, 09:25
Official

Dear ***

Thank you for your post. We will make contact with you shortly.

Kind regards

Shaun Gaines