1 reviews | Active since Jul 2011
Refund
<p>I had to pay for a Dr's visit in advance please find the details to process the claim attached medical aid nr ********** 1445 FD Roodt Id ********** 008089 </p> <p>Account Capitec savings</p> <p>Acc nr ********** 650 </p> <p>Branch 470010</p>
Thank you for your comment, we are currently investigating your query. A consultant will be in touch once we have a result.
Kind Regards
The Fedhealth Online Team
Thank you for your comment, we are currently investigating your query. A consultant will be in touch once we have a result.
Kind Regards
The Fedhealth Online Team
Looks like my claims from Jan was processed on my savings incl my Chronic Medication
Looks like my claims from Jan was processed on my savings incl my Chronic Medication
Because of a mistake Fedhealth made my claim will not be paid
Because of a mistake Fedhealth made my claim will not be paid
claim unpaid
claim unpaid
I WILL NOT RECEIVE A REFUND BECAUSE THE SAVINGS IS EXAUSTED BUT I DIDN'T ASK ANY PHARMACY OR DR TO USE MY SAVINGS ACCOUNT, CLAIMS WAS AUTOMATICALLY DEDUCTED FROM SAVINGS. I SUPPOSE I WILL HAVE TO PAY FOR MY CHRONIC MEDS AS WELL NOW.
I WILL NOT RECEIVE A REFUND BECAUSE THE SAVINGS IS EXAUSTED BUT I DIDN'T ASK ANY PHARMACY OR DR TO USE MY SAVINGS ACCOUNT, CLAIMS WAS AUTOMATICALLY DEDUCTED FROM SAVINGS. I SUPPOSE I WILL HAVE TO PAY FOR MY CHRONIC MEDS AS WELL NOW.
IT DOES NOT HELP TO SEND ME AN ATTACHMENT OF CLAIMS DO YOU DEDUCT MY CHRONIC MEDICATION FROM MY SAVINGS ACCOUNT ? IF I'M NOT MISTAKEN A MALE DOES NOT HAVE A CERVIX. OR DO YOU JUST COMBINE THE FUNDS IF ONE IS DEPLETED ?
IT DOES NOT HELP TO SEND ME AN ATTACHMENT OF CLAIMS DO YOU DEDUCT MY CHRONIC MEDICATION FROM MY SAVINGS ACCOUNT ? IF I'M NOT MISTAKEN A MALE DOES NOT HAVE A CERVIX. OR DO YOU JUST COMBINE THE FUNDS IF ONE IS DEPLETED ?
I Reported the matter to the Council for Medical aid scemes
I Reported the matter to the Council for Medical aid scemes
ONLY STATEMENTS WAS SENT TO ME AS A REPLY
ONLY STATEMENTS WAS SENT TO ME AS A REPLY
Answer from CMS Mrs Begeman
Dear Mr. Roodt,
Kindly note in response to your query below, the scheme responded as follows:
· On the account the Scheme received on 24 March 2017, from Dr Manoussakis (a non Fedhealth specialist partner) amounting to R1, 700 for services rendered on 23 March 2017, this account was rejected as the member had no savings available. The service provider charged for the following procedure codes:
Ø 0192 - New and established patient: Consultation/visit
Ø 2711- Electro-encephalography
Ø 2712- Electro-encephalography
· Upon receipt of the CMS complaint the Scheme found that he above procedure codes forms part of the member’s treatment plan. Please refer to the attachment for the member’s detailed treatment plan.
· The Scheme has reversed and reprocessed the above account. The Scheme will pay an amount of R1,019.80 to the member by 18 May 2017.
· The short payment of 680.20 was due to the account being paid up to the Scheme rate.
Trust that this clarifies your query below.
Kind regards,
Answer from CMS Mrs Begeman
Dear Mr. Roodt,
Kindly note in response to your query below, the scheme responded as follows:
· On the account the Scheme received on 24 March 2017, from Dr Manoussakis (a non Fedhealth specialist partner) amounting to R1, 700 for services rendered on 23 March 2017, this account was rejected as the member had no savings available. The service provider charged for the following procedure codes:
Ø 0192 - New and established patient: Consultation/visit
Ø 2711- Electro-encephalography
Ø 2712- Electro-encephalography
· Upon receipt of the CMS complaint the Scheme found that he above procedure codes forms part of the member’s treatment plan. Please refer to the attachment for the member’s detailed treatment plan.
· The Scheme has reversed and reprocessed the above account. The Scheme will pay an amount of R1,019.80 to the member by 18 May 2017.
· The short payment of 680.20 was due to the account being paid up to the Scheme rate.
Trust that this clarifies your query below.
Kind regards,