PATHETIC SERVICE FROM FEDHEALTH ONCE AGAIN

It's with great sadness that I have to write AGAIN!!!!!

Numerous attempts, back and forth communication and NO claims are being paid!!!!! Fedhealth wants a monthly premium BUT I need to do all the work! I need to communicate with relevant parties and begging Fedhealth!

all claims for my son that was born on the 30th of April 20200

Background: I gave birth on the 30th of April 2022 at Genesis Maternity Hospital, which I got Authorization for. At first they did not want to pay the hospital. the Hospital had to send numerous emails and called several times to get the money. if They have been paid I don't know. No news are probably good news.

The problem comes in with the other providers that assisted during birth.

I am on Flexi Fed 3 and NO NETWORK hospital.

1)Numerous differnt clims were submitted with different codes and still no payout!My midwife was paid in full in 2020 with the birth of my daughter using the exact same ICD codes for the claim. Now Fedhealth says those codes don't exist. I've asked them to assist with the correct codes, which they gave me and still the claims is being put on hold and my midwife was notified that no fees will be paid to her? the claim was for R8500. No issue in 2020 to pay for my daughters birth with the same provider. 23 days later and she is till waiting for payment??????

2) my Doula still wasn't paid. no excuses no feedback. although they told me they will pay for a Doula as this falls part of the Maternity benefits and they will pay up to R3000, nothing was paid. No issue the previous time with my daughters birth in 2020.

3) Private room fee. As part of the maternity benefits I get a Private room. Genesis required the patient to pay this fee upon booking your bed. Which I did, but now they don't want to refund it? R1880 was paid by myself to the hospital, and I gave them proof to show payment was made by myself. No issue in 2020 with the birth of my daughter

4) Hearing screen test . Fedhealth claims that they will pay for a hearing test. after the birth of my baby they tested his ears. a fee of R550 was paid once again BY MYSELF and now fedhealth does not want to pay this, and said they will only pay a mere R191.70

5) ER visit. Due to unforeseen reasons my baby stopped breathing on the 6th of May. I had to rush him to the ER. They don't want to pay because they need authorization! an ER visit needs authorization? Its an emergency??????

6) Hospital admission, My son was admitted on the 17th of May after we had to take him to the ER where they discovered that he had RSV Bronchopneumonia. They only gave authorization for 2 days up until the 19th of May 2022. My son was only discharged on the 21st of May. undisclosed amount due to Pine Haven Netcare hospital

FEDHEALTH WHAT AM I PAYING FOR?????? I'm doing your job daily by following up with doctors and the hospital. Doing exactly what's been asked from fedhealth yet still no claims are being paid????? All claims etc was send through.

I've worked with Gugu who tried her best assisting me but she can also only do so much seeing that Fedhealth put all claims on hold. Either Fedhealth or staff are ***********.

I WILL NEVER RECOMMEND ANYONE TO EVER MAKE USE OF FEDHEALTH!!!!!! in 2020 it was an absolute pleasure to work with FEDHEALTH, sadly in 2 years their service went backwards and to say the least PATHETIC!!!!

Please feel free to contact me should someone feel like doing their job and resolve the unresolved 6 claims....

Regards Sonestha Jonck *** Medical aid n0 ***