1 reviews | Active since Jul 2011
STILL NO ANSWER SEE HP
<p>MY PREVIOUS REVIEW WASN'T RESOLVED I PNLY RECEIVED STATEMENTS AS ANSWERS. I PAID CASH FOR A DR'S CONSULTATION BUT WAS TOLD THAT MY SAVINGS WAS DEPLETED AND NO CLAIM WILL BE PAID.AND THAT I WILL BE ABLE TO CLAIM FROM SARS, THIS IS NOT A SOLUTION. AFTER LOOKING AT THESE STATEMENTS I FOUND THAT EVEN MY CHRONIC MEDICATION WAS PAID FROM MY SAVINGS. I THEN PROCEEDED IN REPORTING THE MATTER TO THE MEDICAL AID BOARD THE MATTER IS STILL BEING INVESTIGATED. SO FAR I RECEIVED ONLY STATEMENTS AS ANSWERS </p>
Thank you for your comment - we are currently investigating your query. A consultant will be in touch soonest.
Kind Regards
The Fedhealth Online Team
Thank you for your comment - we are currently investigating your query. A consultant will be in touch soonest.
Kind Regards
The Fedhealth Online Team
I HAVE BEEN PHONED BY A CONSULTANT AND TOLD I MUST WAIT FOR THE COUNCIL BUT WHAT DOES THIS MESSAGE MEAN THEN ?
Thank you for reviewing my claim
The following claim query has been received and reviewed.
Membership number: ********** 1445 00
Name and Surname: Mr Frans D Roodt
Provider: ********** Dr Manoussakis D
The following claim has been approved and will be sent to be reversed and reprocessed accordingly.
ICD 10: G40.9
Date of service: 23/03/2017
Tariff codes: 0192, 2711, 2712
Kind regards
The ambulatory PMB team
I HAVE BEEN PHONED BY A CONSULTANT AND TOLD I MUST WAIT FOR THE COUNCIL BUT WHAT DOES THIS MESSAGE MEAN THEN ?
Thank you for reviewing my claim
The following claim query has been received and reviewed.
Membership number: ********** 1445 00
Name and Surname: Mr Frans D Roodt
Provider: ********** Dr Manoussakis D
The following claim has been approved and will be sent to be reversed and reprocessed accordingly.
ICD 10: G40.9
Date of service: 23/03/2017
Tariff codes: 0192, 2711, 2712
Kind regards
The ambulatory PMB team
From: Frans Roodt **********
Sent: 26 April 2017 02:54 PM
To: Ronelle Begemann ********** >
Subject: Fedhealth
Good day a while ago i submitted a complaint about Fedhealth but everytime i contact them i get the answer to directly contact the CMS as they do not handle the complaint any longer. A consultant phoned me recently but didn't know anything about the below e mail i received from them. I asked when will the refund be made processed according to the below message. Your help will be appreciated.
Thank You
Good day
The following claim query has been received and reviewed.
Membership number: ********** 1445 00
Name and Surname: Mr Frans D Roodt
Provider: ********** Dr Manoussakis D
The following claim has been approved and will be sent to be reversed and reprocessed accordingly.
ICD 10: G40.9
Date of service: 23/03/2017
Tariff codes: 0192, 2711, 2712
Kind regards
The ambulatory PMB team
The answer
Dear Mr. Roodt,
Kindly note that the scheme’s response is only due on Friday 28 May 2017. We will forward you a copy of the response once it becomes available.
Regards,
From: Frans Roodt **********
Sent: 26 April 2017 02:54 PM
To: Ronelle Begemann ********** >
Subject: Fedhealth
Good day a while ago i submitted a complaint about Fedhealth but everytime i contact them i get the answer to directly contact the CMS as they do not handle the complaint any longer. A consultant phoned me recently but didn't know anything about the below e mail i received from them. I asked when will the refund be made processed according to the below message. Your help will be appreciated.
Thank You
Good day
The following claim query has been received and reviewed.
Membership number: ********** 1445 00
Name and Surname: Mr Frans D Roodt
Provider: ********** Dr Manoussakis D
The following claim has been approved and will be sent to be reversed and reprocessed accordingly.
ICD 10: G40.9
Date of service: 23/03/2017
Tariff codes: 0192, 2711, 2712
Kind regards
The ambulatory PMB team
The answer
Dear Mr. Roodt,
Kindly note that the scheme’s response is only due on Friday 28 May 2017. We will forward you a copy of the response once it becomes available.
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,
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,
resolved thank you
resolved thank you