NM
Ntsoaki M

1 reviews | Active since Sept 2016

16 Mar 2018, 20:09

No feedback and not adhering to turn around time

My mom was booked for Hospitalisation because of Enemia and it was not approved because she is within 12 months so it was sent to underwriting which is not a problem. The issue is I was told it would take up to 72 hours for the approval while my mom is sick , I followed up with the medical aid on 48hrs and the was still no response from the underwriters only on day 2 they call my mom to ask about the details of her treating GP and only on day 3 the forms was sent to the GP to fill the forms. In the whole process the was no one who called us and give us feedback while we are seating home with a sick mother with no response whether they are going to approve or not. I followed up today which is day 3 and was told they await the response from the GP of the form that was only sent this morning which is 72hrs I called the GP to try and speed up the process and was told because their facilities burned he can only scan the form later in the evening I called Fedhealth to notify them of the situation and also asked if they cant then call the GP and ask the questions telephonically the agent that answered the phone said she will escalate and she said I must follow up in the afternoon. I followed up in the afternoon and still nothing was done and day 3 is gone its going to weekend meaning we will have to stay with our sick mom till Monday. My question is why cant Fedhealth be proactive when a person is sick and due for Hospitalisation on the underwriting side , we agree they have 3 days but I am sure it can be used wisely and speedingly minding the health of the patient , I do believe that as they say family takes care of family they can be proactive update your client , make sure that the turn around time is adhered to and the life of the patient is not at risk. I am disappointed with Fedhealth I have been with them for 3 years hence I recommended it to my family and we chose is for my mom when she needed medical aid and also my sister is with fedhealth and the entire family but this treatment is really worrying .But having to wait for underwriting that is not proactive slowly doing things and not giving feedback is frustrating. If they say 72 hrs can they start from the 1st hour to collate the information so they don't prolong the process and also update their client .We are heading weekend and probably nothing will be done until Monday and the excuse will be the GP did not response but the GP was contacted late and they had issued with was indicated. My mom s member number is ********** 1122 Esther Maluleke and my name is Julia Maluleke I can be contacted at ********** 409

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Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply19 Mar 2018, 10:07
Official

Thank you for your comment, we will do some investigating and an agent will contact you shortly.

Kind Regards
The Fedhealth Online Team

NM
Ntsoaki M's update19 Mar 2018, 14:43
Reviewer Update
Thank you for the prompt response and also for dealing with the matter urgently and professionally .All is sorted and my mom is in Hospital. Thank you to Boitumelo for the extra information on Hospitalisation terms and conditions and the discharge information that we will need to be aware of.
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply26 Mar 2018, 10:39
Official

A consultant has been in contact with you and detailed feedback has been provided.

Kind Regards

The Fedhealth Family