LK
Lerato K

1 reviews | Active since Oct 2018

17 Oct 2018, 17:39

DO NOT JOIN FEDHEALTH MED SCHEME!!! They do everything in their power not to pay claims

DO NOT JOIN FEDHEALTH MED SCHEME!!! They do everything in their power not to pay claims. I was admitted into hospital and my admission was preauthorized by FEDHEALTH. Whilst there I had to have tests done which included RADIOLOGY tests. Before this was done the medical aid was contacted for authorization for the procedure. They agreed to Pay R4000. The procedure cost R6000 so R2800 was for my onus. I was notified this by the Radiologist and I signed in agreement. This was in July 2018. It is now Oct 2018 months later and I get a bill from the Radiologist saying the medical aid refused to pay because I had been suspended - which was not the case as this would NOT have been pre authorized - similarly my stay in hospital would have been unauthorized. Now I'm being thrown from pillar to post seeking answers. No one seems to know what's going on and every time I speak to someone I get a different story. First the claim has been paid, but I have a bill in front of me that clearly shows a reversal, which the agent on the line confirmed herself. Then the supervisor will call me back by end of day - needless to say four days later I'm the one having to hound them again. Then the credit controllers aren't available. Now I have spoken to another supervisor who has promised to call two days from now. BUT NO ONE CAN TELL ME WHY MY BILL HASN'T BEEN PAID. I am so frustrated and angry and feel hard done by. These people are ******...the worst medical scheme I've ever been a part of. DO NOT JOING FEDHEALTH - THEY ARE ********!!!

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Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply18 Oct 2018, 11:22
Official

Thank you so much for your message. We are currently investigating your query and an agent will contact you shortly.

Kind Regards
The Fedhealth Online Team