RL
Roxanne L

1 reviews | Active since Jan 2018

08 Jan 2018, 10:29

3rd trimester of pregnancy discovery refuses me a authorization number for birth of child!!!!!!!!!!

I have been a discovery member since 2014,in 2017 i had a change of employment and been on and off discovery for 5 months in October i went back on effective Nov 2017, when my medical aid was approved i was told no underwriting , no waiting peroids etc. I advised a consultant on the 02/11/17 i am going for some tests as i might be ill if i require a auth number will there be any problem seeing as i just joined again ,she said NO hassle we will be able to issue with one no problem depending the outcome of the results of all the test. After numerous test & appointment with my gynie it was established i was pregnant and 5 months in fact . After getting over the news myself. Went to back and forth doctors appointments and scans to confirm the baby is healthy and Iam in good health ( fetal scans, more blood tests etc) i called again on the 21/12/2017 to get a auth number for the birth in 2018 , i was advised by the consultant to rather call in Jan 2018 for the new year as i have just upgraded my plan as i had full confidence in discovery never ever had a issue or concern over the years. I called on the 02/17 to get my auth number i was advised by the consultant i was referred to the " standards dept"i questioned what is this she just advised they will get a letter from my gynie confirming my pregnancy and when i find out etc and not to worry. TO MY HORROR on the 03/01/2018 in the afternoon i got call from PHUMELO of your standards department who sounded so uninterested and tired i should of known this call was going to go downhill. i was advised by your unhelpful consultant that SHE is declining my auth cause she FELT basically i was LIEING and knew i was pregnant all this time etc. Me being in state lost my cool as not once was this mentioned that this would be problem but she advised me ONLY she has access to this information!!!!!! I was being cross - examined from when my peroid was to what birth control i was on one would swear she was a qualified DR! ( Bear in mind this is the first i have requested a auth number form Discovery so had no idea of process etc and i made her aware of this )After a screaming match i put the phone down, I was advised i will be getting a email where i can dispute etc IAM still waiting I requested a ref for the call she told me she cant give me one i must just use her NAME .I called back on the 04/01/2018 i spoke to a Nicole in another department who advised the procedure etc very helpful , i advised Nicole no one called my gynie to confirm anything and she said that's weird and called the standards department and was told they dont HAVE to do that anymore. She was as shocked as i was at that comment. IAM highly STREESED as iam now having to run around get forms and dr letters to confirm iam in fact pregnant and not lieing to submit to you forensic standards department ,get quotes for a private birth etc BUT iam on medical the best in the country apparently. WHY MUST I GO THROUGH THIS !! IS THERE NO TRANSPARENCY IN DISCOVERY!!! I JUST WANT A AUTH NUMBER THAT'S IT I DONT DENY YOUR MEDICAL RATES FOR PAYMENT WHAT AM I PAYING FOR TO BE HUMILIATED BY A GIRL THAT DOESN'T EVEN LIKE HER JOB!

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Replies (3)
Discovery Health
Discovery Health's reply08 Jan 2018, 13:17
Official

Dear Ms RD Layman

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.

Regards
Discovery Health Servicing Team

RL
Roxanne L's update08 Jan 2018, 14:03
Reviewer Update
I Just got a text stating my Medical Aid has been SUSPENDED!!!!!
Discovery Health
Discovery Health's reply10 Jan 2018, 14:35
Official

Dear Ms RD Layman

Please check your emails for feedback from us.

Regards
Discovery Health Servicing Team