Our Services

When a medical scheme declines to reimburse a patient’s treatment, the patient is referred to our Case Manager. The case is logged, and an assessment takes place. The assessment determines what type of case we are dealing with and filters the case to the next step. The case is then referred, with the patients signed consent, to the best-suited resource that could aid them in navigating their journey, be they internal or external service providers.

Our Case Managers provide these cases with the knowledge and tools to access the treatment and answers to questions they require. Patients or their caregivers, treating doctors, and practice authorization staff are aided in coordinating the information and resources needed to escalate their dispute effectively.

Case Managers are specifically trained in dealing with all aspects of the dispute resolution process, effectively holding the patient’s hand every step of the way to ensure they get the results they need. This process is backed up with specially developed tools. These tools have been created with the assistance of medical, support and legal experts.

Please note that patients details are kept strictly confidential and never revealed to clients as this would go against our privacy protocols and legislative requirements.

We commit to providing the following services to patients:

ACCESSING TREATMENT and PATIENT ADVOCACY: we will help the patient, caregiver or family member navigate their way when accessing the treatment they are entitled to, regardless if they are being treated in a state hospital or belong to medical aid, and advise them on the best ways to deal with workplace situations arising from their  diagnosis.

Types of ACCESS TO TREATMENT and PATIENT ADVOCACY issues we can help with:

Guiding the patient, caregiver or family member through the steps of exercising their rights and processes of appeal with regards to:

  • A medical scheme declining their treatment plan or not correctly allocating their treatment in relation to their benefits.
  • Helping the patient, caregiver or family member develop treatment motivations for submission to their medical scheme.
  • Helping the patient, caregiver or family member apply for ex gratia funding with their medical scheme.
  • Helping the patient, caregiver or family member with their cancer diagnosis and treatment services in public hospitals.
  • Problems with referrals in public hospitals.
  • Unfair treatment in public hospitals.
  • Unfair treatment in the workplace.

With rights come responsibilities and we require that the patient, caregiver or family member be aware of their responsibilities towards the process. (This is stipulated in our Patient’s Terms & Conditions)

DON’T TAKE “NO” FOR AN ANSWER.

Are you having trouble gaining access to treatment?

  • You have the right to ask: WHY?
  • You have the right to be given an explanation in a way that you can understand.
  • You may even have the right to receive the treatment you were previously denied.

So don’t just take “NO” for an answer, ASK “WHY” ASK NOW!

If you would like to know more about your rights as a patient or need assistance in confronting your medical scheme, call us NOW and ASK!

Patient Onboarding Form

Log An Authorization Dispute
  • Supporting documents

Things to remember

  • Keep your cool! Do not get angry with the person on the other side of the line. If you get mad, you may not get through to the person who will solve your problem.
  • Always keep records of who you spoke to, when it was and what was said. Keep copies of all correspondence, emails, faxes, SMS’s etc. If you have to submit documents, do not submit the originals and always keep an extra set of copies in a safe place.
  • If the discussion or response is in a type of language you do not understand (medical terminology, legal terminology, abbreviations or acronyms). Ask the person who wrote the letter to give you an explanation in a manner you understand – it’s your RIGHT!
  • There is a law that you can use to access any information from your medical scheme. It is called the Promotion of Access to Information Act (PAIA). You can use it to get copies of letters, discussions, finding, recording of telephone conversations, etc from the scheme.

General

According to the law, ASK Now may not act on your behalf or even begin to manage your case until we have your signed and duly completed patient consent form (“the form”). The form will be sent to you by our Case Managers and is to be emailed to casemanager@asknow.co.za

All reasonable measures shall be taken to prevent the unauthorized access, processing or disclosure of the patient information to third parties. We will only disclose information to third parties if you have provided us with your consent in terms of the form for us to disclose information, on your behalf, to such third parties as may be required in order to resolve any query that you have concerning your treatment.

ASK Now will provide callers with general information about patients rights relating to employment. However, such information is not intended to be a substitute for professional legal or medical advice. Never disregard professional legal or medical advice.

With rights come responsibilities, we require that you, as the patient, be aware of your responsibilities.

Your responsibilities include –

  • to provide ASK Now and your health care providers with all the relevant and accurate information about your condition for diagnostic, treatment, rehabilitation or counselling purposes;
  • actively participate in the navigation and endeavor to provide the information requested by your Navigation Case Manager, promptly;
  • complying with the prescribed treatment or rehabilitation procedures;
  • enquiring, from your medical services providers, about the related costs of treatment and/or rehabilitation and arranging for payment thereof;
  • taking care of and keeping track of your health records;
  • respecting the rights of other patients and health care; and
  • utilizing the health care system properly and not abusing it.