1 reviews | Active since Jun 2015
unbelievably confusing
Yesterday I left my work as I was suffering from immense abdomanil pain. My doctor then wanted to admid me to hospital to do the proper tests and put me on the right medication. Clearly he also thinks that this is serious. Topmed then said they can not give authorisation code unless my doctor fills out a non dec form stating that it is not a pre existing condition. As soon as topmed sent the forms my doctor filled it out and sent it back. After several people told me the forms were recieved yesterday, I was told this morning that they havent recieved it. Eventually they found it and told me that they can't give me authorisation because I wasnt treated for this condition before. So nothing really makes sense what they said. According to Justin. If its a pre existing condition. They will not give authorisation. But then this morning they said I wasnt treated for it before and therefore will not get authorisation. Can anybody explain this to me? All of this after spending almost R500 worth of airtime in one day and still I sm sitting with so much pain. Why have a medical aid if they are not willing to get you the medical help you need? I will never recommend topmed to anyone!
It is a standard process that if you have recently joined the Scheme and call for an authorisation for admission that we check if the admission relates to a pre-existing condition. Hence we then request your doctor to complete the Clinical History forms to confirm.
We have followed this standard process as you have only joined TopMed on the 01/06/2015 and requested for an admission on the 09/06/2015.
Upon receipt of your forms our underwritng department reviewed your clinical history and confirmed that this is not a pre-existing condition.
Further to that we have also noted that you have not received any conservative out-patient treatment as yet for this condition. We app**** clinical protocols to your admission and indicated that we can't release authorisation. In order for us to approve an admission for abdominal pain we require evidence that conservative treatment was received out of hospital and that this treatment fail. Only then we can release an authorisation for admission.
Kind regards
Yolandi Knoetze
It is a standard process that if you have recently joined the Scheme and call for an authorisation for admission that we check if the admission relates to a pre-existing condition. Hence we then request your doctor to complete the Clinical History forms to confirm.
We have followed this standard process as you have only joined TopMed on the 01/06/2015 and requested for an admission on the 09/06/2015.
Upon receipt of your forms our underwritng department reviewed your clinical history and confirmed that this is not a pre-existing condition.
Further to that we have also noted that you have not received any conservative out-patient treatment as yet for this condition. We app**** clinical protocols to your admission and indicated that we can't release authorisation. In order for us to approve an admission for abdominal pain we require evidence that conservative treatment was received out of hospital and that this treatment fail. Only then we can release an authorisation for admission.
Kind regards
Yolandi Knoetze