Authorization Nightmare

I am due to go in for a C-section on 27 July 2021. I submitted my pre-authorization request with Fedhealth on the 25 June 2021. To date I have still not received my authorization number despite regular telephonic and email follow ups.

On the 28 June, following my authorization request, Fedhealth phoned to say they needed to confirm that I was not aware of my pregnancy before rejoining the scheme. I answered all their questions and provided them with the details of my GP and pharmacy as requested. Up to this point I did not have any issues with Fedhealth. They paid for obstetrician/gynecologist visits and scans, sent me regular baby update emails, phoned to see how my pregnancy was going and even sent me a baby bag. All was well and I was impressed with their support, but now that a serious claim lies on the horizon things have changed radically.

It took 3 days and a follow up email before Fedhealth even bothered to contact my GP for the information they required. It took them 2 weeks and several more follow up phone calls and escalation requests to contact the pharmacy for additional information. Needless to say Fedhealth could not even get the pharmacies' email address right and I had to step in and ensure that the request and forms were actually received by the pharmacy.

Both the evidence provided by my GP and the pharmacy confirm that I was not aware of the pregnancy at the time of re-joining Fedhealth. From talking to several other Fedhealth members and former Fedhealth members it has become very clear that this is normal behaviour for the scheme and that they are well known for delays in granting authorization and a general unwillingness to pay for procedures, even if they are meant to be covered. This is just a stall tactic used by Fedhealth to try to avoid paying and I do not appreciate their tardiness and incompetence in handling this matter.

I have never previously claimed from any medical aid (I was with Fedhealth for many years before having to briefly cancel my membership due to financial reasons) and am extremely disappointed. I hope that I did not make a huge mistake by re-joining them. I am scheduled to see my obstetrician/gynecologist later this week to finalise the paperwork and do a final check. The lack of response from Fedhealth is extremely stressful as the hospital will require some sort of authorization or deposit before finalizing my bed booking. I don't have that kind of cash lying around, that's why I have medical aid!