I have resorted to submitting my medical aid claims via Hello peter instead of getting the doctors to invoice /bankmed, because this is the only way to get them paid these days. On the 19/11/2013 the Authorisations clerk called the authorisations dept and requested authorisation for an emergency CT scan according to bankmed (carecross) the wrong ICD 10 code was used and authorisation was denied at the time. the only time the patient was notified of this was ofcourse when we received the doctors bill. ( wether the wrong code was given by the Authorisations clerk or mis-intepreted by the bankmed consultant i cant say, my invoice From doctor however has the correct Pre-scribed medical benefit code on there. Hence my confusion and the 110 phone calls between doctors and medical aid) Now they might be able to fix this error provided they can get an injury report from the hospital and some other paperwork . ( how is this my fault) Now because somebody up I might have to pay R2150 out of my own pocket. I get the feeling bank med is trying to dodge PMB claims as this is not the first time i have to fight to get things sorted .yet they can deduct their premiums on time.
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