AfricaComplaints.com » Health & Medicine » Complaint / review: Fedhealth Medical Scheme - Inhospital everything is not covered | #71660

Fedhealth Medical Scheme
Inhospital everything is not covered

Laparoscopic procedure requested authorisation never sent to me was told, call hospital authorisation to confirm if it was sent.
Co payments: no amount indicated on this procedure for my option. (queried)
hospital auth advised that there was no amount indicated on the auth form this amount is determined by the hospital, clients services advised that there was an amount and this was sent on the 25/02/13. hospital confirmed Fedhealth determines co payment.
Claims for Dr services rejected advised that Dr is not listed under the auth # must call clinical to add Dr Practise # then call Client Services to reverse and reprocess, which i"ve done. then client services advised me Dr was part paid and that he over charged (this was the anaesthetist which fedhealth has listed as a GP according to auth Dept) Hospital short paid As Per fedhealth hospital over charged. hospital advised fedhealth rejected as length of stay. Tariff code 58001.Can someone please listen to the call i'm given conflicting stories from various dept in fedhealth and my query is not being resolved. (In hospital unlimited) yet hospital is not being paid at 100% nor is the anaesthetist. this is ridiculous!

Date:

Company: Fedhealth Medical Scheme

Country: South Africa   City: Call centre

Category: Health & Medicine

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