Fed Health ... FED UP!

On the 30th of August 2021, I woke up excited knowing I would be viewing my unborn baby at the doctors office. What started off as a perfect Monday morning resulted in a WEEK FROM HELL. When I got to the doctors office, he found an infection which could be detrimental to myself and my unborn baby. Due to the seriousness of my condition, the doctor sent me to Flowpath urgently to have blood work done in anticipation of my hospital admission. He then sent me to Lenmed Shifa Hospital where I was than turned away as Fedhealth did not authorise my admission. After a few phone calls to Fedhealth trying to get authorisation, I was than informed that my pregnancy was under investigation and sent to underwriters for approval.

(It is important to note that prior to all this Fedhealth had approved my maternity benefits as well as share in my excitement with weekly emails regarding pregnancy).

That same day I received a phone call from the under writer or should I say "Interrogator" where I was questioned all the way back to 2015 regarding my medical history. All in all, after many phone calls of following up, and begging for admittance due to the urgency my mine and my babies condition, eventually on Friday the 3/09/2021, after being told to wait for a call, I eventually phoned and was told that the investigation was finalised and I was approved.

I was given Reference number FED***0 and told to give the hospital this reference number when I went in on the 6th of September. After a week in hospital, I was discharged on the 10th of September feeling great and ready to face the world.

On the 14th of September, I received a phone call from Flow path as well as a statement from my doctors office saying that my claims for the 30th of August were denied authorisation from Fed health.

On the 15th of September 2021, I phoned Fedhealth, thinking this was just an overpass on their side due to the confusion they created for themselves regarding the investigation but was told that they would not authorise the bloodwork or my doctors visit for the 30th of August as there was no hospital admission done, when I informed them that I did eventually go to hospital on the 6th of SEPTEMBER till the 10th of SEPTEMBER and would have gone on the 30th of AUGUST if I had not been placed under investigation, they told me that regardless they would not authorise these procedures as I was not admitted to hospital, they than said that it would be paid from my medical vault.

I asked to speak with management and as is always the case I cannot be put through but will email a referral to management to contact me, I am still waiting for a phone call and no full well, I will not receive it.

For a company with a motto that says " Our medical aid benefits give members what they need when they need it,", Fedhealth surely seems to be failing in this regard.

The zigzag fashion that my case has been handled shows that to Fedhealth I am nothing but a number in their grand pyramid scheme, they are quite happy deducting money from my account every month but when its time to fulfil their promises they are quick to come up with pitiful excuses.

It clearly shows that Fed health delayed my hospital admission for a week, their reasons for not authorising my claim payment is null and void and I am prepared to take this to the Council of Medical schemes and fight tooth and nail, even though I hope it won't come to that and Fedhealth will stop pretending that they are unable to override their system and fix the problem easily.