MS
Mmaphuti S

1 reviews | Active since Jun 2015

09 Jun 2015, 13:14

Claim paid but i was told they wont pay

When i joined the medical aid i was told that o will only have. 2 specialist visit per year and i must get referral from my Gp, i went to see my gynaecology on the 10th March and i went with the referral, the scheme paid the claim, on my second visit on the 7th April i didn't have a referral, they sent me a statement month end of April confirming that they wont pay because i did not get referral from the Gp, i didn't argue that so i went to the gynae and paid cash, and i knew that i still have one visit left, so i sent an email last week to confirm that but o was surprised to be told that i don't have any gynae visit. Left, i wanted to know why, i they sent me an email confirming that they have paid the claim for the 7th April. On the 4th June 2015,so why. Did they pay the claim now when they told me they cannot pay it, i was suppose to go to the gynae next week so how am i going. To pay for that visit, if i didn't call to ask if i still have any visit, when were they going to tell me, and what made them to pay the claim in june when i went to the doctor in April, something does not add up, and this makes me wonder if they will pay my maternity benefit next week,

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Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply09 Jun 2015, 13:59
Official
Hello Kedibone91,

Thank you for letting us know that you are less than happy with the service you have received. Please allow us some time to look into your query and we will get a consultant to contact you as soon as we have some news.

Kind Regards
The Fedhealth Online Team