Bankmed
Pre authorised procedure now not being paid

My little girl of 4 years old went in for a removal of a portwine stain on her leg which was authorised by bankmed before the procedure: QHA0826347. The authorisation was done on a special basis as this procedure is not always covered in the bankmed benefits. On the authorisation letter it specifies that the doctor and procedure will be covered at 100% scheme rates, now when I have sent in the account for payment an amount of R5300 is being rejected stating the procedure code is not covered in the scheme benefits. How is this possible if the procedure was authorised and it stated in the authorisation letter that the procedure will be covered. Why then give authorisation if it is not going to be paid?

Company: Bankmed
Country: South Africa
City: Claims department

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