dV
deon V

1 reviews | Active since Jul 2012

04 Feb 2020, 12:53

How many times

All the physio claims submitted by the KEET AND BESTER PHYSIOTHE******S you guys declined and a lady from Fedhealth phoned me and said I am covered until the 26 of December for 30 day after care which include Physiotherapy. I would like to know why you guys decline all the sessions. In hospital it was submitted under practice number *** and was approved but I was asked if I want to go to their office in Centurion after I left hospital which has a practice number ***. All my physio dates was scheduled before 30 day after care was done. The 30 day after care must be approved under practice number :*** because they submitted it under the hospitalization code ***2 electronically.

Still not satisfied with my request regarding the physio account. I am covered for 30 day after care and the physio in the hospital was paid and when I left hospital I moved to another physio from advice of the physio in hospital and the fact that it is different practice numbers they decline my claim. I don't know how many times I must say fedhealth this. They Only come back every time with the answer I already know but they don't come back how to rectify the problem because I am covered for 30 days. If I go with physio A in hospital and then go to physio B outside hospital the fact is I am covered for physio. If the accident happened in cape town and I stay in Pretoria must I drive to Cape town to get my treatment? The physio did submit the Hospital auth number but we get every-time rejection and it does not make sense and if I ask how can we fix this issue then now one can answer. I would like to speak to the guy who rejects the claim not the call center claims agent because they just submit it to the guy who reject it.

0
Replies (2)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply04 Feb 2020, 12:58
Official
Thank you so much for your review we will be in touch shortly.

Best Wishes
The Fedhealth Online Team

Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply12 Feb 2020, 12:04
Official
A consultant has been in contact with you and detailed feedback has been provided. 


Kind Regards 

The Fedhealth Family