JP
Jo-Anne Pretorius

1 reviews | Active since Sept 2024

17 Sept 2024, 17:46

CLAIMS ARE THROWN OUT FOR NO REASON (TWIN NICU STAY)

My twin babies were born in August 2021 - they were immediately taken to the NICU as soon as they were born because they were premature and needed extra assistance to survive. IMPORTANT TO THIS STORY: THEY ARE TWINS. They were in the NICU for a total of 13 days as they needed oxygen support, could not maintain their own body temperatures, and needed feeding via intubation. They also had not developed the suck, swallow and breathe reflex because of their prematurity and needed the NICU assistance and time to develop this reflex. For context, this reflex ensures that they can feed without choking or stopping their own breathing. Fast forward to 2022 and I get an astronomical account from the Hospital because Fedhealth decided they would only pay for Twin 1 in NICU and not Twin 2. Just so we are all on the same level of shock – Twin 2 was the smaller of the babies she was tiny in her weight and in her stature due to being twins and due to prematurity. I questioned why the claim has not been paid to the hospital with Fedhealth during this time in 2022. And I still have that same query outstanding from 2022 on Fedhealth’s system - it was never resolved. I never received a proper response as to why it was rejected. And I doubt I ever will. They just refused to pay for Twin 2 on their own accord. Can someone please advise me who gives a medical aid the discretion to decide which twin should have support in the NICU and which should not. This boils down to a question of who gets to live and who gets to die. I’m sorry but how does the Medical Aid get to decide this? How is this acceptable practice? Fast forward to today - I am now being sued by the attorneys of the hospital as the bill has never been paid. Fedheatlh has never given a response in verbal or in written format to me as to why they decided Twin 2 was not eligible for her NICU support. I am still fighting this as it is gross misconduct, inhumane and completely ********* and mostly just unfair and unjustified. I have concluded that Fedhealth: 1.) Does not care about the health and well-being of their patients as is evident in my case. 2.) Are only out to make money off you and will make sure they throw out any claim they can in the hopes you will tire of the battle and pay the astronomical hospital bills yourself. Please do yourself a favor and STAY FAR AWAY from this place. I am not the first that this has happened to, and I can assure you I will not be the last. Please don’t let it be you next.

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Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply18 Sept 2024, 09:26
Official
Dear Member,
 
Thank you for submitting your feedback to us, we are sorry to hear about your experience. One of our consultants is already attending to your request and will respond to you shortly. 
 
Best wishes,
Fedhealth
JP
Jo-Anne Pretorius's update18 Sept 2024, 09:43
Reviewer Update
This is merely an automated response from Fedhealth - means nothing to me. Please resolve my query.
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply18 Sept 2024, 11:23
Official
Dear Member,
 
Thank you for submitting your feedback to us, we are sorry to hear about your experience. One of our consultants is already attending to your request and will respond to you shortly. 
 
Best wishes,
Fedhealth