Shocking service and

Your query number is : 031219QSF0B9. After sending numerous mail - and no reply and not being able to speak to a representative that can assist, I am hoping that some answers will be given:

On the 8th of November, I contacted Fedhealth to obtain authorisation for a procedure which my husband had to undergo on the 21st of November. I provided the agent with all the necessary ICD codes and the practice no for the doctor. I was issued with an authorisation no. and told that the entire procedure would be covered (this can be heard on the voice recording). The authorisation no provided was ***7. Once I had obtained the authorisation number, I assumed that the procedure had been approved and made the necessary arrangements for my husband to undergo the operation.

On the 21st my husband was checked into the Clinton hospital at 6am. The operation took place at about 9.10am. Fedhealth contacted my husband (on his phone) which my son had and would not provide any information. At about 11am, the hospital administration staff approached my husband – who had just come out of anaesthetic to inform him that Fedhealth had only sent through the approval at that time and a R14,000 co payment was due. I immediately contacted the medical aid and was informed that the procedure had only been approved at 11am and there was in fact a R7,800.00 co-payment due.

Firstly, why was this approval only done almost two weeks after my initial call for authorisation. Why was I not informed on contacting the call centre that such a massive co-payment was now due? I am now out of pocket with R7,800.00 which has not been budgeted for. If Fedhealth had provided me with the facts prior to undergoing the operation, I would have been able to make an informed decision and also prepared myself for the absolute shock of having to pay out a massive amount.

Please can this matter be urgently investigated, and please can we receive answers as to why an authorisation number was provided and why were wee not informed that a co-payment would be required. I don’t feel that this matter was handled in a professional manner as it was embarrassing to be informed that we had to pay before my husband could be discharged – at no fault at our own.