RM
Raaksha M

1 reviews | Active since Oct 2009

08 Apr 2021, 14:29

A CRUEL ORGANISATION

My son was born with a con******* ear tag to which requires removal. Upon enquiring with Discovery in November 2020, I was assured that this procedure was covered and that it will also be covered in the future as this is definitely funded by the scheme. The correct codes were provided to the Scheme as per the surgeon who recommended we only proceed with the surgery after my son turns a year old. The consultant even went to the extent of doing a pre authorization on the phone for me to reassure me that it’s covered. 2 weeks ago we scheduled the surgery with this in mind only to be declined and be told that the agent made an error and that my sons surgery will not be funded. I have tried to escalate the matter and was promised that it will reach the correct person who will call me with an answer but this has not been the case. I have had to cancel my sons surgery because it is financially not possible and this has caused both me and my wife huge emotional distress. I have subsequently submitted a complaint to the executive office and have still not heard anything from them. I ask that they honour what they have told me and that they cover the surgery for my son. The surgeon has also said that they cannot understand why they have subsequently declined the procedure as this is something that he has been born with and not developed after birth. I sent an email to the executive management and 3 working days ago, no acknowledgement of my mail at the least. I called in today, spoke to a lady Elize, she promised to call me back, nothing. Nobody seems to care yet my childs surgery never went ahead because of DISCOVERY!

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Replies (5)
Discovery Health
Discovery Health's reply09 Apr 2021, 07:14
Official
Dear Raaksha

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

RM
Raaksha M's update09 Apr 2021, 12:31
Reviewer Update
So now after having sent my dispute form over a week ago, and resending to the manager Aluta who confirmed that she received this, I now get an email to say it’s incomplete. Now tell me is this an organization who actually realises what business they are in! That they are not some retailer who’s selling makeup? I will now have to resend this whilst they don’t give a stuff about the impact of their incompetence and pure don’t care attitude. This confirms that their clients are just numbers!!
Discovery Health
Discovery Health's reply09 Apr 2021, 14:39
Official
Dear Raaksha

We contacted you to discuss your query.

Regards Discovery Health Servicing Team
RM
Raaksha M's update09 Apr 2021, 14:46
Reviewer Update
No you contacted me to say that a person by the name of Carol has been trying to contact me from a private number and that it doesn’t come through. That is incorrect as I get private number calls often as I have advised you. Last but not least you could not provide any information on my query and merely called to say that this Carol person will call me. You advised that you don’t have any information on my query. So let’s not me misleading on your responses. There was no DISCUSSION on my query.
RM
Raaksha M's update11 Apr 2021, 22:44
Reviewer Update
It’s now 3 days later and no call from Discovery. The lady Trish blatantly **** that the manager Candice / Carol couldn’t get hold of me as she was calling from a private number. I did tell her that I receive calls from private numbers often but gave her the benefit and gave her my husband’s number who is the primary member to call. They have not called him either. This was a lie because if they were genuinely trying to get hold of me she could have transferred the call. Instead she further lies and says she doesn’t know about the query. So how did she manage to get through to me if I am so unreachable? Does this talk to INTEGRITY. I will be taking my issue to the OBS.