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forssmans F

1 reviews | Active since Jun 2016

19 Jul 2021, 13:06

How Fedhealth contributes to Covid Trauma.

My 80-year-old mother contracted Covid but fortunately she was not experiencing any respiratory difficulties, which was a blessing as she suffers from multiple co-morbidities. She was however very weak, fainted sometimes, and could not walk by herself or take care of herself. With times she was also a bit delirious. The doctor/s recommended home care, for a number of reasons and her own survival was one for the possibility of my mother not surviving a stay in hospital was real. I am Cape Town based, and mother lives with my sister and her husband in Vereeniging, Gauteng and they both had Covid at the same time as my mother, which made the whole situation worse and quite an emergency. We were fortunate enough to secure the home nursing services of a home care facility soon enough and they were able to start providing care for my very sick mother on 12 June 2021, which was a Saturday and thus afforded my sister and her husband the opportunity to take care of themselves and recover from Covid. My mom is a member of Fedhealth and has been for years. That is where our real battle began however. I had to get the authorization from Fedhealth because my family members were too sick to deal with this as well. Since 14th of June I have sent in excess of 10 emails to Fedhealth. We have received authorization for the homecare on 28th of June, and I have submitted the first invoice to be paid. And since then it has been a run around from pillar to post one email after the other - to phone is of no use because they tell you to send an email to the claims department. Which I have done. Multiple times. With my mother's particulars and membership number in the subject line. And I would receive an email back asking for my mother's particulars andmembership number! This is not even half of the frustration. Every single email I have sent was a request for more information, without any guidelines on how to do it really, as if everyone outside of Fedhealth knows exactly how to submit a detailed invoice quoting all the codes and such because we are magically expected to know how to do this. What makes it worse, the caring facility that provided the home care, is a Church organization and they are desperate for their payment, but Fedhealth will rather send yet another email asking for further details which I have sent to them numerous times. I have even highlighted and circled the information in my correspondence. But still no. People working at Fedhealth cannot figure out that if the patient's name and membership number are in the subject line of the email, that that is who the claim pertains to. It is like they are just careless, and if you don't s****feed the information they want exactly to them the way they want it because they don't want to figure things out by themselves or they don't have the capacity to do it - not that there is much to figure out, - they just throw another email at you and they can keep the system going like that for another month or so... because Fedhealth and because they can. And that is the way they operate. No further assistance forthcoming, just red tape, and red tape and more red tape. In the meantime, there are caregivers who are waiting for payment. One ought to make this a much bigger thing: Something titled " How Fedhealth contributes to Covid Trauma because that is exactly what they did. I am at my wit's end with them. I am trying to help my mother here and I am trying to secure payment for the caregivers who so lovingly looked after my mother when she needed it most and I often wonder what would have happened had my mother ended up in hospital. The cost would have been astronomical.

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Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply19 Jul 2021, 13:43
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
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply12 Aug 2021, 09:49
Official
Dear Member, we tried to contact you however couldn't reach you. A detailed email has been sent to you.

Best Wishes
Fedhealth
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forssmans F's update01 Sept 2021, 11:45
Reviewer Update
That is absolute BS - my phone rang once and went dead before I could even answer it! - Please don't try and excuse your dismal attendance to matters as "tried to contact you and couldn't get hold of you"! What do you consider trying? And your detailed email is just more of the same BS - a detailed account is required, one that I have sent multiple times over and over and over. And yes, I phoned straight back after "you could not get hold of me", and I spoke to Quinton, who told me there is in actual fact nothing wrong with my documentation, but that the claims department was probably just too lazy to do their work properly!! He even undertook to phone me back straight away or to get someone to call me back after he has spoken to a supervisor or some important person who obviously assists you in your jobs to do nothing. Yes, Quinton did NOT phone back - and I have NOT heard anything further from Fedhealth - so there you have it - who to believe?!