COMPLAINT

I have been with Fedhealth for many years now, and i never really had a problem with them, i guess that is because i never used them. Now when i need to use them, they are being extremly difficult. If you are with FEDHEALTH and have a Care Plan with them, make sure that they have the correct ICD Codes in place. That is the problem i having with them, they gave me a fantastic Care Plan, but you have to use their chosen ICD Codes, I tried explaining to them if an ICD Code is changed to suit them, it changers my condition. They need to work with the specialist's codes, not make up their own codes. I am battling with them since March 2021, i am now at the point where i have to pay my bill myself because they refuse to listen to me, and the pathologist account is way over due. I am very unhappy with this bad service that i am getting. Let me give you an example: They said that they will pay for 18 Prothrombin Time - A Prothrombin Time (PT) is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder. I have been diagnosed with DVT, which is a blood clot. But when asked why they are not paying for the tests to be done, they said that the ICD Code is incorrect, i then asked them what codes are they using, they have linked that to DIABETES. How can the pathologist change their codes if that test is being done because of a DVT condition. FEDHEALTHS APMB Department does not know what they are doing. Futhermore when i had my baby in hospital, are not all costs surpose to be covered? The gyne requested for stockings to be arranged for me, medical aid refused to pay for it, even though i was in hospital, they said the stockings has nothing to do with maternity. This what i am dealing with, and i am so fed up, God forbid i have an emergency and need to be treated. They cannot even treat a normal query, how will they deal with a huge problem. My parents are with Discovery since forever and not once have they had a problem. FEDHEALTH is becoming sloppy with their service. You cannot get through to any managers there either, you waste your time leaving messagers and no one calls you back. VERY POOR, BAD SERVICE :( Elizabeth