Just poor administration

Below was sent to Fedhealth *** who was requesting information of a member AMANDA LEE GREEN ID *** who had to leave the hospital Garden City due to been misinformed and other delays. There is now on record from the doctor at Garden City that whist he understood the financial burden the patient will face due to FEDHEALTH's issues, he would rather keep her hospitalised. And guess what happened, the patient blacked out again in the hospital.

Fedhealth and CureMed,

This matter is now formally escalated.

Through administrative failures at Fedhealth and repeated assurances from the CureMed broker that cover was in place, Ms Amanda Lee Green (suspected neurological symptoms) was compelled to leave hospital to limit personal liability. She is now clinically vulnerable at home, afraid to seek urgent care for fear of further financial exposure. Your organisations have created an unacceptable and foreseeable risk to patient safety.

This is grossly negligent service and a dereliction of duty toward a member who re**** on your representations. It is also inconsistent with basic obligations of accuracy, timeliness, and member protection.

Immediate remedy required (deadline: today):

Immediate pre-authorisation for Ms Green to be admitted to a network hospital for finalisation of neurological assessment and care.

Written confirmation of authorisation (ref no., facility, attending physician) and that Ms Green will not be exposed to out-of-benefit liability arising from your error.

Correction of records to reflect her correct identifiers and treating physician, with confirmation of POPIA rectification and deletion of any incorrect records.

Named case manager and direct contact number for coordination with the receiving hospital.

If not resolved by the stated deadline, we will:

File urgent complaints with the Council for Medical Schemes and relevant ombuds,

Request written reasons for your decisions (PAJA), and

Reserve all rights to seek redress, including costs associated with delays and distress caused.

Treat this as a priority patient-safety issue. Please respond in writing with the authorisation reference and admitting facility by the deadline above. Even a remedial task of retrieving patient information shows evidence of maladministration in that they cannot even get the patient's information correct, adding to further delays.