So last year July I took my son for circumcision. The Dr called Bestmed to get the authorization number. Once the authorization was obtained, I then took him in to Louis Pasteur hospital. The option I had on my medical was Primecure, so once all was done, the Dr sent a claim to Primecure. Primecure then rejected the claim, although there was an authorization number. Primecure didn't bother to follow up on anything till I got the bill from the Dr. I referred this to primecure and they sent a mail to Bestmed to assist and check the authorization number. Bestmed never replied on any of the mails, till again I had to make a follow up. This time, Indira from Bestmed replied and handled the issue. All of a sudden I am being told that Bestmed will not cover this as it is now a stale claim although I had referred this to them. How can it be a stale claim when they can prove that the Dr had submitted to Primecure and Primecure also confirmed same? Now they're refusing to pay R1100 after I had paid them for 5yrs without fail? Really Bestmed??? Your service is shocking and I will be referring this to the Ombudsman as well.
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