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Cassandra C

1 reviews | Active since Aug 2020

20 Nov 2024, 13:35

Please avoid Dis-Chem Health!

I have had the WORST experience with Dis-Chem Health. I have the Plus Cover as well as accidental cover. My daughter injured herself on Friday (15 Nov), and since then it has been a nightmare with getting authorisation. We received the GOP for Melomed Gatsville. Melomed Gatsville then wanted to transfer my daughter to Redcross hospital, as they do not accept the GOP for admission. I was not happy with this as we do have cover for in hospital stay. After 5 hours of back and forth with Dischem Health (Netcare 911 as it was after hours) a consultant advised that after agreement between the 2 hospitals Melomed Gatsville and Netcare N1 City and the Health Insurance I need to take her to The receiving doctors' office on Monday, 18th November as the arm was too swollen to operate. They also advised that I need to call the Saturday morning to get the GOP prior to the going the Monday. I called just after 8am the Saturday and was told to email ***. I did so. I did not receive a response until the Monday (18 Nov) stating that the GOP for admission will not be processed as my child was discharged on Friday and it is now seen as a follow-up. This is after we followed the instructions of the consultant at Netcare 911 on Friday. I have been back and forth with the case Managers since Monday the 18th. I informed them that the Doctor advised that the arm was still to swollen and that he scheduled the operation for Wednesday, 20 Nov at 13:30. After countless email, countless calls. I was informed at 12:28 on 20 Nov 2024 that the request has been declined because my daughter was discharged on Friday, 15 Nov. As per the Doctors advise this operation is an emergency that was beyond our control. The Doctor has also tried to contact them to get approval which he did not receive! I am now sitting with a situation where my daughter needs to receive surgery for an ACCIDENT that occurred that was beyond our control, The Surgery is a need as the arm will not grow as it should, and the GOP was DECLINED! I am terribly and utterly disappointed! This is AFTER Following the INSTRUCTIONS by Dischem Health!

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Replies (1)
Dis-Chem Health (Medical Insurance & Gap Cover)
Dis-Chem Health (Medical Insurance & Gap Cover)'s reply20 Nov 2024, 13:57
Official
We apologies for the inconvenience you've faced with our claim process, Cassandra. Your feedback is important to us, and we want to make things right. We assure you that we have taken the necessary steps to resolve this issue.