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gavinedw G

1 reviews | Active since Dec 2016

17 Aug 2018, 09:04

Fedhealth - A "Family" that doesn't seem care

Fedhealth Website invites prospective clients to, "Join the Family", they actually say, "Looking for an established medical aid that treats you like family? ". Fedhealth goes on to say, "Run by members for members, we’re a scheme governed with a completely transparent approach where every member is important."

My current experience with Fedheath Medical Scheme has been ANYTHING but being part of a family. As far back as October 2017 when Mr Nadeem Shaik Madar presented a very smooth sales pitch offering the world, yet delivering only headache after headache. In fact his sales pitch of "you are completely covered for accidents emergencies eg Broken bones, even during the 3 month waiting period" was just that, a sales pitch nothing short of being blatantly inaccurate and untrue! Out of the waiting period, my Elderly mom (72) had a terrible fall in April 2018 resulting in a complicated open fracture of her Ankle. While the bills are now heaping up, one after the other, our "Family" at Fedhealth seem to do all they can to reject, avoid and ignore claims. Trying to speak to our "Family" at Fedhealth is more like trying to communicate with the estranged cousins, wife. Fedhealth medical Scheme has NEVER answered an Email on the same day. I have lost track of the number of emails that have simply just not been answered. My parents exist on two Elderly Pensions (R3200) + a little bit of financial help from myself (very little), The benefits and overall service received DOES NOT Justify the monthly membership fee of the medical scheme, Prosthesis (Emergency Admission): Rejected. "Moonboot" (Post Op) (3 Motivations): Rejected. Physician Consultations (In Hosp / Emergency Admission): Rejected. Designated GP Visits (Panel Dr): Rejected. X-Rays (In Hosp / Emergency): Partial Payment. Emails Ignored: (04/06/2018 20/06/2018 21/06/2018 27/07/2018 28/07/2018). Calls not returned. 5. The cherry on Top... In a "Family" one finds a hierarchy with a head of the Family, Ask to speak to the Head of the "Fedhealth family" (The CEO) and the reply is that the CEO doesn't speak to members, in stark contrast to the "transparency" Fedhealth offers. Nope, NOT every member is important to the Fedhealth Family, especially the elderly!

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Replies (4)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply20 Aug 2018, 09:25
Official

Thank you so much for your comment. We will do some investigating and an agent will contact you shortly.

Kind Regards
The Fedhealth Online Team

Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply02 Oct 2018, 09:44
Official

A consultant has been in contact with you and detailed feedback has been provided.

Kind Regards

The Fedhealth Family

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gavinedw G's update15 Oct 2018, 13:57
Reviewer Update
I have received Feedback From Ryan. I believe that the issues raised have now been resolved. Ryan was brilliant by doing thorough investigations and providing detailed feedback on each matter. I would like to thank Ryan for the effort that he put into resolving these issues.
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gavinedw G's update15 Oct 2018, 15:52
Reviewer Update
IT would seem that unless the issue is dealt with by Ryan, the rest of the Fedhealth staff / Consultants have been conditioned to be obstructive, useless and downright frustrating. Ryan had restored my faith in Fedhealth actually providing customer care. I was promised after the Hello Peter post that things would improve and I received a heartfelt apology for the manner in which previous claims had been dealt with. 13 Days later, and Fedhealth is again proving that providing customer services isnt really what they are in the business of. Having had a second operation on the SAME injury, after a follow up consultation to the Orthopedic surgeon today, a Walker boot has been prescribed, a Motivation letter has been written with the ICD Codes, with a script from the surgeon. Emailing the request has yielded no response. I have spoken to THREE consultants. I am told that they need to put me through to someone else. Again I need to argue that I do have written consent to discuss this issue, the consultant tells me I am NOT on the system. My Honest feeling is that Fedhealth has a LIST of reason why NOT to honor claims: 1) You are authorised to discuss this matter 2) You are through to the wrong department 3) I first need the practice number 4) Have you sent the email. 5) We have a large call volume 6) Our system is very busy 7) I need a reference Number 8) Its Not a PMB , we only pay PMB's 9) We need a Motivation (Despite having SENT the Motivation, They want the dr to Motivate a MOTIVATION) 10) "We haven't received your email" 11) "We are working on the matter" 12) "I just need to put you on hold." 13) "I need to submit this to the right department" 14) "I can not process this without the Motivation" 15) "We haven't received your email, there is no other email address you can you, I can only get the email off the system" ( I used Fedhealth Customer Services ********** ********** ********** 16) Karabo states I wont submit the motivation to PMB department, she then changes her mind but state that the motivation is incomplete, when I ask if I can put the doctor on the line, say states they dont deal with doctors. 17) Ryan assisted previously with actual results -> "I can not put you through to Ryan" (1hour 57 minutes minutes on the phone, trying to get Auth for a Walker Boot) (9 Emails: 12h34 / 14h02 / 14h21 / 14h27 / 14h31)