SC
Shay C

1 reviews | Active since Jan 2019

22 Jan 2019, 14:08

Fedhealth ********** Medical aid claims

I am very displeased with their claims department. I have been paying for medical consultations that I am not aware of. I currently reside in Johannesburg but there has been claims paid out for medical practitioners in Bloemfontein. I have contacted their customer service center and the consultant gave me the contact numbers of the practitioner and said I must investigate the matter myself. The cellphone number that was given belongs to a guy who said he was a prison warder and the telephone number does not work at all. i then proceeded to log a query ( twice) on their website after a large sum was paid to a bio kinetics practitioner. I have never consulted for such. I am extremely frustrated because I do not even know how to proceed to sort this out when i have to carry out ***** investigations by myself. My details are now in the hands of ********* and my medical aid savings are getting depleted every single day. Fedhealth does not seem to care about their clients.

0
Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply22 Jan 2019, 14:29
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 

The Fedhealth Family
 
SC
Shay C's update22 Jan 2019, 14:58
Reviewer Update
No, that is not satisfactory. The feedback provided was that i must contact the practitioners and tell them to reverse claims. How do i recoup money that has already been paid. I called before the claims were paid to get ahead of this. At this point, I just want my savings to be paid back. This is absolutely *********** on your claims department. If I log a query that should be a red flag to not pay out claims until you have validated with the client that they are legit. I will repeat, I cannot be chasing random people asking for my money back when i logged a query to show that I was disapproving of the claim. Also, this is just an isolated incident, i have not mentioned the one where a doctor was paid twice for one claim. Unacceptable. If you guys do not contact me with a valid solution I will be taking this further to the ombudsman. I cannot investigate ********** claims on my own.
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply28 Jan 2019, 12:03
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 

The Fedhealth Family