NB
Nomzamo B

1 reviews | Active since Feb 2017

06 Apr 2022, 14:56

7 months later they fail to settle a claim and come with an excuse of not paying because Dr practice is under investigation.... ******* medical aid

I thought my previous complaint on this medical aid would be the last that's the reason I decided to continue with them for year 2022. So on the 29/09/2022 I was rushed to Unutas ER then admitted, the Dr who was on call or on duty wasn't on my medical aid network doctors. So the money was deducted from my savings at first then when I queried it was when the partial was paid from RISK. Then I queried why was it partially paid then i was told that because Dr is not on their Network, I then said but the hospital is on Network and in the ER I cannot choose which doctor attends to me then they advised me to get motivation from the Doctor. I paid for that motivational letter then send it to Fedhealth. And they have been promising to pay after 3 days every time i queried as it was now approved to be fully paid from risk. I then escalated again and i was told it's a technical issue they're attending to because when they try paying it gets deducted from savings and they'll sort it out. So for five months same story, on the 15th of March 2022 i get an email that the practice is under forensic investigation now they cannot pay them. How is this my problem because they've confirmed and promised to pay from risk. So suddenly they cannot anymore?

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Replies (2)
NB
Nomzamo B's update06 Apr 2022, 15:05
Reviewer Update
The date is 29/09/2021 not 2022
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply06 Apr 2022, 15:21
Official
Dear Member, 
 
Thank you so much for your message, we are sorry you’re having such a bad experience, please bear with us while we do some investigating.  One of our consultants will be in touch with you as soon as we have a result. 
 
Best Wishes
Fedhealth