TopMed thinks I'm a ****
<p>Dear TomMed. I am, to say the least, utterly digusted and disappointed with the treatment that I have received from you guys since I joined the scheme. My in hospital treatment of October 2016 has still not been paid out till today. In October 2016 I was advised by a medical specialist to immediately be hospitalised as I was not responding well to tests undertaken. The scheme had preauthorised this. After having to spend a week in hospital, I was finally diagnosed with multiple sclerosis (a chronic condition). The medical aid thereafter continued to make me feel as though I brought this condition upon myself by saying "I always knew I had M.S". This for me was them trying to run away from paying anything. It felt as though doctors had to almost beg for the scheme to provide medication for me. I have had the worst few months in my life as I have had to deal with lawyers and people calling me requesting for IN HOSPITAL payments. You guys have brought me more stress and made the acceptance of my life long diagnosis impossible to deal with. I am forced to approach the media at this point and call TopMed out for their incompetence throughout this.</p>
Dear Nomazizi
We do apologise for the delay in releasing your authorisation, however the non-disclosure investigation is a standard procedure which takes place when a new member is admitted to hospital within the first year of membership with a possible long standing condition. The turn around time on the investigation depends on how quickly we receive the medical questionnaires back from the treating doctors, we have been in constant contact with them regarding the outstanding documentation.
Further feedback will provided to you once the investigation is completed.
Kind regards,
Chanele Schoonraad
Dear Nomazizi
We do apologise for the delay in releasing your authorisation, however the non-disclosure investigation is a standard procedure which takes place when a new member is admitted to hospital within the first year of membership with a possible long standing condition. The turn around time on the investigation depends on how quickly we receive the medical questionnaires back from the treating doctors, we have been in constant contact with them regarding the outstanding documentation.
Further feedback will provided to you once the investigation is completed.
Kind regards,
Chanele Schoonraad
Thanks for your response. TopMed must just understand that I do want a good relationship with the scheme but it would also be nice for the scheme to not just reject the claims and give invalid reasons for their rejection. The scheme should instead tell the parties that are contacting them for payments the current status of the process so that all properly understand. Also, lawyers have only given me till 9 Feb 2017 before they proceed with legal action. If TopMed still hasnt responded after 5 long months then I too will have to cut the relationship and seek legal advice against the scheme. I do however appreciate the lady that was working on my case from non-disclosures she in fact is the only person that treated me with respect and dignity throughout all of this.
Thanks for your response. TopMed must just understand that I do want a good relationship with the scheme but it would also be nice for the scheme to not just reject the claims and give invalid reasons for their rejection. The scheme should instead tell the parties that are contacting them for payments the current status of the process so that all properly understand. Also, lawyers have only given me till 9 Feb 2017 before they proceed with legal action. If TopMed still hasnt responded after 5 long months then I too will have to cut the relationship and seek legal advice against the scheme. I do however appreciate the lady that was working on my case from non-disclosures she in fact is the only person that treated me with respect and dignity throughout all of this.
Also, all of the relevant documents requested by the medical aid for the doctors to fill in "the questionnaires" have all been submitted now (with additional supporting medical reports not requested for). So please can TopMed process as quickly as possible now.
Also, all of the relevant documents requested by the medical aid for the doctors to fill in "the questionnaires" have all been submitted now (with additional supporting medical reports not requested for). So please can TopMed process as quickly as possible now.