TM
Theolenta M

1 reviews | Active since Dec 2019

10 Jun 2023, 01:28

Disgusted and fuming by poor service

You would expect that after giving birth you'll get support and proper assistance from your medical aid. I mean amidst all the overwhelming things that are happening you'd expect that the least of your worries will be the medical aid not paying.... if there was ever a time I was disappointed by a company unable to uphold being professional and delivering service its now and its with key health. How it is possible that ive activated a benefit (maternity ), I give birth and stay at a hospital and have my claims paid but for the child rejected. So yall paid that i gave birth but not the person I birthed, not the pediatrician who was there for the child either. Explain how it makes sense that yall sat there and decided that we will be liable where as you can see claims are being sent through from a hospital. Now we are left with debt and shame from being called by the hopsital like as of we ran away after they provided us with their service. This is absolutely ridiculous, why not process the claims and just modify once the parents have settled and sent in the birth certificate. Why not call and congratulate the parents then just give them a heads up to send through whatever thats necessary. But regarless the childs fees where supposed to be paid and settled seeing that the mother was on your maternity program . Why pay for the mother and not the child. Please make it make sense for me what exactly did yall expect the outcome of me using the maternity program was going to yield??? . Right now my child is sick and I cant take him to the hospital coz even after the countless times the father has called and emailed for you guys to register the child it still hasnt been done. Im really dissapointed and now im running up and down with a new born and medical bills that shouldve been paid

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Replies (3)
Key Health Medical Aid
Key Health Medical Aid's reply12 Jun 2023, 08:19
Official
Dear Theolenta M

We regret to hear about your negative experience, and we appreciate you bringing this matter to our attention. We will investigate your comment and respond back to you.

Sincerely,

The KeyHealth team

 

Key Health Medical Aid
Key Health Medical Aid's reply12 Jun 2023, 12:37
Official
Dear Theolenta M

As we confirmed with you here above, we investigated your concern.

We can assure you that KeyHealth operates in accordance with the Medical Schemes Act 131 of 1998 and are regulated by the Council for Medical Schemes. Factors such as legislation / Scheme rules will always be app**** on all applications for membership irrespective if it is for a principal member/dependant/new born. 

It is important to note that when a baby is born, we will require the below information as soon as possible after birth of the new born.
  • Copy of unabridged birth certificate/proof of birth from hospital.

PS: Babies must be registered within 30 days of birth.

Subject to the rules, the Scheme may impose upon an application for a baby(s) not registered within 30 days after birth, from the first day of the month following the month the application form was received, with a three (3) months general waiting period and/or a possible 12-month general waiting period. The 1st enquiry we received for the registration of the newborn was on 08/05/2023, by our principal member; this was more than 30 days after birth. 

We will forward an e-mail feedback response to our principal member's e-mail address as well. Feel free to contact us if you have any further concerns: ***.

Sincerely,

The KeyHealth team
Key Health Medical Aid
Key Health Medical Aid's reply13 Jun 2023, 14:10
Official
Dear Theolenta M,

Kindly refer to the e-mails sent yesterday to our principal member, as well as the one sent today, we cc you in the feedback today. We discussed the waiting period imposed for the baby, and the steps to follow to appeal for the baby’s date of the registration.

The Pediatric visits request has been referred to our Disease Risk Management department, for review and feedback. We also discussed all the claims submitted to KeyHealth and the payments of the claims for the hospital admission 29/3/2023 - 03/04/2023.

KeyHealth will no longer be engaging on the issue on Hellopeter as all the relevant information has been provided to our principal member via e-mail.

Should you have any further enquiries regarding the matter, kindly contact our client services department on Telephone number ***or forward an e-mail to ***.

Sincerely,

The KeyHealth team