CW
Chris W

1 reviews | Active since Mar 2015

12 Mar 2015, 14:50

Very bad service

A week before my procedure I called to get a auth number for a procedure.Today is 10 days after the first time I called,I have already been for the procedure ( Because it is a serious condition which these call centre people do not understand ) that I had to pay upfront and still no auth number.At first they told me that I have a waiting period because I am a new member but according to my contract there is no waiting period.then they told me that they will have to investigate my medical history and if they do find that I have been for a similar procedure they will not pay.Then I was told that I have to wait for the committee to make a decision,but no one in that company can tell me who or where the committee is.If I could see into the future I would not need a medical aid.I am leaving all my details and would like to speak to someone that actually knows what is going on and that would not drop the telepnone in my ear.

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Replies (1)
TopMed Medical Scheme
TopMed Medical Scheme's reply12 Mar 2015, 15:14
Official
Hello chrisr1,

When signing your application for you indicate to the Scheme whether you are having any symptoms that you would seek treatment for in the next 12 months.

You joined the Scheme on the 01/03/2015 and requested an authorisation for a procedure on the 09/03/2015. It is a standard process to verify that this condition was not pre-existing before joining the Scheme.

Our underwriting department has reviewed the request and have referred it to the Non-Disclosure Committee to review.

Feedback will be provided to you shortly.

Kind regards
Yolandi Knoetze