sR
shabbir R

1 reviews | Active since Mar 2012

30 Sept 2020, 10:20

fedhealth medical scheme

i am a gp .and saw a patient from fedhealth. at the time of consulting the membership validity and available funds were checked .i was paid .then fedhealth wants me to repay the amount aftyer it was found the bpatient had ldefaulted with payments.i must pay the money back .why they dont claim it from the patient.this is there reply The membership was terminated and back dated to the 31/01/2020 due to non-payment of the monthly contributions, the membership was terminated on the 19/05/2020, this means that the member was still active on the time of the consultation in the month of February 2020, the benefits were confirmed correctly and the claims were paid accordingly, however due to the member defaulting on payment the scheme had to reverse all accounts by paid as the member did not belong to the scheme any more at the time of consultations.

The member is liable to settle the accounts with the service provider.

As per the scheme rules signed and agreed by the member ,should the member default on the monthly contributions, benefits paid by the scheme on behalf of the member shall be reversed from the respective service providers and payment of these claims shall be for the members account.”

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Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply30 Sept 2020, 10:51
Official
Dear Member, thank you so much for your message, we are sorry you’re having such a bad experience, please bear with us while we do some investigating.  One of our consultants will be in touch with you as soon as we have a result. 

Best Wishes

Fedhealth