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Gary C

1 reviews | Active since Oct 2019

18 Oct 2019, 17:40

Fedhealth are ******** and refuse to give authorizations for spinal and neck injuries even though these are included in PMB condtions list

I was rushed into hospital after a collision with a car while training on my bicycle. Fedhealth has since the accident never paid for any claims relating to this accident and emergency. Then after waiting more than a year to get into a neurosurgeon in Nelspruit and getting a scheduled procedure for rhizotomy, Fedhealth declines authorization for a procedure that i have been waiting for for almost 2 years! They gave all sorts of excuses and even told me the specialists and neurosurgeons don't know what they're talking about as Fedhealth claims facet infiltration's are the same as Radio Frequency Rhizotomy's. I have been in chronic neck, back and shoulder pain for almost 2 years and i have got to the point where i cannot use the right side of my upper body normally. This has debilitated my function and quality of life to such a degree that i cannot function properly.

Fedhealth claims that 'Family Looks after Family'. But i can tell you it's misleading and false advertising and they definitely do not give a damn about the health of their clients! If they did they would look at my case and see that i have been a loyal client for more than 8 years and that i have a serious problem with my neck that needs an urgent medical attention.

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Replies (2)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply21 Oct 2019, 08:41
Official
Thank you so much for your review we will be in touch shortly.

Kind Regards
The Fedhealth Online Team

GC
Gary C's update21 Oct 2019, 14:07
Reviewer Update
Fedhealth digital media trolls quick to respond, but again your lack of medical knowledge and your unwillingness to understand the medical facts prevails! You fail to understand the difference between a facet infiltration and a Radio Frequency Rhizotomy. Again you say your medical codes reflect that these are the same, again proving that your descriptions and the medical procedures are incorrect to your convenience. You are failing to acknowledge and understand that i have sustained a neck/ spinal injury as indicated by two specialists being orthopedic surgeon Dr Kevin Steyn and neurosurgeon Dr du Preez. A fractured vertebrae with compression between multiple levels of the vertebrae and a mass pushing against the spinal cord is not a reflection of a perfect spine but rather a damaged spine as a result of an accident. Yet you want to negate this and refuse to authorize an urgent procedure, one that will end my suffering of almost 2 years. As far as i can see and the literature reflects according to the Council of Medical Schemes, these conditions and injuries fall within the prescribed minimum benefits (PMB) list, yet you refuse to assist! I have now logged a case with the council of medical schemes! What you are doing is trying to avoid the cost of covering this procedure at the expense of your paying customers.