TM
Tazz M

1 reviews | Active since Nov 2011

21 Jun 2016, 04:55

Processing until we are all blue in the face

<p>My husband is blind and had prosthesis fitted on 21 April. We had to pay more than R18000 to the service provider. We obtained approval from Fedhealth prior to the fitting. Once we submitted the claim we waited 2 weeks and then were informed that it had not as yet been processed. I submitted a complaint and lo and behold it was processed and an amount of R9940 was refunded to us. We then submitted an application to the ex gratia committee and waited a month until they met. Finally we recieved approval from ex gratia for an additional amount to be made available to us for external prosthesis. I called the call centre and was informed that no further action was required from our side as Fedhealth had the approval and initial claim. I called back yesterday and was informed that the claim is now resubmitted for processing. If we already have approval what exactly is the need for reprocessing? It has been almost two months. What exactly are we waiting for this time? We have approval. you have proof that we made payment.. You even refunded us the initial amount. This is a typical example of Fedhealth dragging its feet for something that extremely straightfoward. Why do I need to complain to recieve prompt resolution? Refund our money. We are not a huge entity that can afford to wait for your long winded protocols that make no sense.</p>

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Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply21 Jun 2016, 07:16
Official

Thank you so much for your message. We will do some investigating into the matter and a conusultant will be in touch shortly.

Kind Regards

The Fedhealth Online Team

Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply27 Jun 2016, 12:05
Official

A consultant has been in touch to speak to you about your query in detail. We trust that you are happy with the result.

Kind Regards

The Fedhealth Online Team

TM
Tazz M's update01 Jul 2016, 08:42
Reviewer Update

Sorted out by Boitumelo within a day. Payment was recieved and my faith in Fedhealth restored!!!