NO PAYMENT FOR (PMB) HEART SURGERY!

On 2 October 2015 I had a major heart bypass operation performed by Dr L Rampini after being in ICU stabilised after cardiac arrest on 26 September 2015 - this was a major medical emergency and I had no choice of hospital or surgeons/drs. They saved my life by performing the bypass surgery. HOWEVER Fedhealth has not paid Dr Rampini nearly R85 000.00 and in spite of numerous attempts and 5 reference numbers I get no feedback what so ever. Now I am being called by Drs demanding payment. <br> <br> I was told that as this was a Prescribed Minimum Benefits (PMB) emergency - a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected<br> <br> PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of: any emergency medical condition of which 'Heart Attacks' is listed as one of the 15 categories and cardiac failure as one of the chronic diseases covered!!! Its ironic that they save your life then stress you out more. Next course of action will be Medical Aid Ombudsman.<br> <br> <br> <br>