FEDUP with fedhealth - fedhealth suck

<p>I am beyond frustrated with fedhealth (fedhealth does not deserve the respect from me to be written with a capital F).</p> <p> </p> <p>1) My dad had to go an see an ENT on 17 May 2017.</p> <p>2) I phoned and spoke to Elazia on 10 May 2017. Explained the health plan option they are on and she checked and confirmed that the doctor was on the network and gave me authorisation. My dad went to see the doctor, he paid the R650 cash and we submitted the claim to fedhealth.</p> <p>3) The claim was rejected stating that the doctor is not on the network. Other reason received was that the 2 allocated specialist visits have been depleted. Yet, this was the first visit. Also, does not seem like fedhealth knows what they are doing.</p> <p>4) Since that date, I have spoken to the below consultants:</p> <p>- 26 May 2017 - Sikolile</p> <p>- 29 May 2017 - Rose</p> <p>- 9 June 2017 - Dudu</p> <p>- 26 June 2017 - Joshua</p> <p>- 28 June 2017 - Mbali</p> <p>- 7 July 2017 - Dudu</p> <p>- 7 July 2017 - Lindiwe</p> <p>- On multiple occasions - Manie (The team leader)</p> <p>5) First of all, your staff are all poorly trained. I have been passed from pillar to post. They do not know how to resolve a simple query.</p> <p>6) Second to that .. they do not know how to keep promises. They keep making promises that they will phone back, yet nobody does and my phone bill is sky high due to all of the calls.</p> <p>7) The first person that did something about this was Lindiwe that requested for the call to be listened to.</p> <p>8) At this stage, she transferred me to Manie (the team leader). Manie confirmed that the call has been listened to and that the agent gave me incorrect information and therefore due their fault they will refund the R650.</p> <p>9) Manie promised to phone me back on 17 July 2017. I still have not heard anything from him. I phoned on 18 July 2017 and I spoke to Deon, apparently Manie is not available.</p> <p>10) In the meantime, I have received an email to say the claim has been re-processed, but rejected due to the fact that the 2 x specialist visits have been depleted. How can it be depleted if this is the first time anybody on this plan went to a specialist?</p> <p> </p> <p>1) How many more times must I phone fed(up)health?</p> <p>2) How many more times must I explain the story to every agent I speak to, because getting hold of Manie is not a simple and easy process?</p> <p>3) How many more times must the claim be resubmitted and rejected for stupid reasons?</p> <p>4) How many more months must we wait for the refund?</p> <p>5) Should we rather mover the medical aid to a new provider? Clearly fed(up)health makes way to much money and does not need it's members. Do they even value their members?</p> <p> </p> <p>Please do not reply with some standard response on how this is being investigated. Get it sorted and process the refund. I am really tired now to keep repeating myself over and over.</p> <p> </p> <p>I have reference numbers for all of these calls.</p> <p> </p> <p>Maybe this will get the attention it deserves. Oh and just incase maths was not a requirement when staff were hired, 17 May to 18 July = 2 months ... unacceptable!!!!!!!!!</p>