AfricaComplaints.com » Health & Medicine » Complaint / review: Fedhealth Medical Scheme - Terrible service & lack of empathy | #224186

Fedhealth Medical Scheme
Terrible service & lack of empathy

I am totally disgusted at the complete lack of service we have received from Fedhealth's hospital pre-authorisations department. My husband has to undergo cataract extraction surgery on Tuesday the 8th of October at the Johannesburg Eye Hospital. I was totally shocked and appalled when I received a call from the opthalmologist's office, advising that the procedure was pre-authorised, but a co-payment of over R 3000 is payable. This is completely unacceptable, as cataract removal surgery is a PMB procedure, that HAS TO BE COVERED 100% in full, as per LAW. I called the pre-authorisations department this morning to log a query, and had the total misfortune of having to speak to Katlego. He was not only patronizing, but also rude, and kept on interrupting me. He also didn't know what he was talking about, first he told me that the co-payment is due because we are using an out of network provider, then he said that it's because of plan rules. Both of these instances doesn't warrant a co-payment, as a co-payment CANNOT BE IMPOSED ON A PMB CONDITION. I requested to speak to a manager, but apparently his manager was "in a meeting". PLEASE remove the co-payment ASAP and contact me?

Date:

Company: Fedhealth Medical Scheme

Country: South Africa   City: Pre-Authorisations

Category: Health & Medicine

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