SG
Samantha G

1 reviews | Active since Dec 2011

08 Nov 2016, 13:54

Lies lies and more lies

<p>At the start of this year I received an email explaining that I now had a careplan for my diabetes. This meant not only was my chronic medication going to be covered but blood tests and doctors appointments necessary to adequately care for my illness. In June I started to use this careplan as I was going for my yearly check-up. I had blood tests, went to see a diabetic doctor and most recently a podiatrist. Of the 10 blood tests that were supposed to be covered only two were. I queried this and you paid another one but an amount of R381.70 was still outstanding. During various communications with Fedhealth they kept using the excuse that the ICD10 codes were incorrect even though I showed them that they were correct. One person even said the main diabetes test, an HBA1c test, was not necessary to care for diabetes. The appointment with the doctor came out of the day-to-day because he was also a GP on the network. The podiatrist was not covered at all. He intially used the wrong the code but once it was corrected they only paid a third of the account and once again used the excuse that the codes were incorrect. Why do you have a care plan if have no intention of paying out? Furthermore, this is not something that is an added extra. It is something that is LEGALLY required. On top of that it is something that has been legally required since Fedhealth ended their CDE plan but whihc I have been paying for out of my pocket the last few years. I want my money back. I am sick and tired of asking and asking for the same thing but your *********** fools never getting it right. I am giving you a chance to fix this immediately before I share this on every possible social media platform and go to the Health Professions Council of SA. FYI - I will sh*@t bricks if you tell me the codes are incorrect one more time...</p>

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Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply09 Nov 2016, 10:34
Official

Thank you for your comment, we will follow up and a consultant will be in touch!

Kind Regards
The Fedhealth Online Team