Lindsay Marshall openly speaks about how managing the administration of her breast cancer diagnosis became yet another battle, and then how she developed a proactive way to make the road less bumpy.

When I was diagnosed with breast cancer, in August 2015, there was so much thrown at me. The gamut of emotions, how to tell young children, and, of course, the intensive treatment that would end up taking a year. What took me most by surprise was the large amount of admininstration required to manage treatment, medical costs, and insurance, etc.

NAPPI codes

I was thrown headlong into this when I tried to get a wig. My medical aid had sent me details of the oncology benefit, where it clearly stated the allocation for a wig. I duly went along and purchased said wig. After which I forwarded the invoice for reimbursement, and then the fun began. 

The invoice kept getting refused because there was no NAPPI code on the invoice. The wig itself is, of course, not a medical item. Many people wear wigs for a variety of other reasons. 

Needless to say, I spent countless hours trying to explain this to the  claims and oncology department. It caused complete confusion. I felt I was teaching them what their benefits were! It was only after repeated escalations that it eventually got paid.

This all happened when I was trying to come to terms with my diagnosis. It did nothing for my stress levels. It was clear that the claims process was out of sync with the benefit plan as it did not allow for paying an invoice without a NAPPI code. I soon realised that, as the patient, it was going to be critical to  play a proactive role in managing the treatment, associated bills and logistics that comes with it.

Managing paperwork

The admin side of going through extensive treatment is a dispassionate, unemotional and bureaucratic pain in the neck that causes so much unnecessary stress. By trial and a fair amount of error, it was these four things that helped me when it came to managing the paperwork.

Medical aid:

Understand exactly what your oncology benefit covers. Do your treating doctors claim directly  from medical aid or will you have to pay upfront? Make sure bills are being paid from the oncology benefit and not impacting on your other cover by checking your claims statements all the time. Make sure invoices are clear and have all the information required. There is nothing more frustrating than having to resubmit and go through the whole process again. 


When I was diagnosed I used a lever arch file with month file dividers.You may prefer to do it by category. Keep everything: invoices, scans and blood test results, reading material and copies of prescriptions. I took it to every appointment and every treatment session. It gave me a semblance of control over the whole process.


With the emotional stress and treatment (Yes, chemo brain does exist), I found it was very hard to remember everything. Times of my appointments, what to ask the doctor, what the doctor said, what I needed to do or take. The list went on and on.  Being able to write it down was so important. Although, I sometimes forgot that too, hence my next point below. It was not anything special just a place to jot things down. The number of times I wrote down reference numbers from the medical aid was frequent. What I soon realised, was that my doctors were seeing countless patients, and medical aids have thousands of members. I needed to be my own advocate. Keeping a record of discussions helped me to do this.

Ask for help:

I refer here particularly to dealing with the admin side of treatment. When my brain couldn’t work, or I was curled up in my bed unable to move from the nausea, it was my husband who phoned the medical aid. He followed up on appointments, and when I had forgotten to write down questions for the doctor, he remembered and asked them himself.

Lindsay Marshall (41) is a breast cancer survivor. She lives in Weltevreden Park, Gauteng with her husband and two children.

MEET OUR EXPERT – Lindsay Marshall

Lindsay Marshall (41) is a breast cancer survivor. She lives in Weltevreden Park, Gauteng with her husband and two children.