1 reviews | Active since Sept 2014
Authorisation nightmare from Discovery
This was the last resort as I lie awake again after a sleepless night due to pain 🤦♀️🤷🏻♀️🙈
So I join discovery and I am now passed the waiting periods for non specified conditions. I go to my dr with the worst pain approx 3 months ago. I actually could barely walk and I was in a state. He checks me out and obviously cannot make a decision as I needed X-rays etc. so I have an X-ray and the X-ray indicates nerve compression and some other conditions, he refers me with sciatica? So he refers me to a neurosurgeon who checks me out and says it’s possibly my hip so off I go to the orthopaedic surgeon who sends me for 2 amRI’s to check my hip and my lower back . So at this point discovery approve the 2 MRI’s and the sports benefit and it was assumed that I could do physio and get this sorted. No way the pain escalates and back to the Neuro I go who then says my hips are perfect but my back has issues and he is hesitant to operate as once they start I will need 3 separate operations and the pain will still be there. He subsequently closes his practice and moves to another province.. He suggests conservative treatment and off I go to another Neuro to get a second opinion which is identical. Pain management, then physio to try and strengthen my back and core to avoid surgery at this state. Great news because lots of surgeons are scissor happier and love operations. Get referred to pain specialist and that’s where all the drama starts. They are booked up for 6 weeks as they only do procedures on a Friday. They approach discovery and my claim gets approved . Wow I am happy I can get the excruciating pain addressed, as if 🤷🏻♀️🙈 Turns out the authorisation was an error and they now want PMA form from the diagnosing Dr , I explain he has closed his practice and moved so it will be challenging. No they say he must complete it. I mention my GP was actually the first one to see me, they wanted to confirm I did not have this condition when I joined. Fair enough. So off we go 4 weeks later they still on a mission to get the Neuro to complete the form. Despite my broker, the dr room and myself explaining he closed the practice. Then they decline the claim - reason pma form not completed 🙄🙈🤦♀️ Then the crisis continues and I miss two more opportunities to go for this pain block procedure . Ok so let me explain. I am on targinect 2 x a day which is part of the opioid family and another pill which numbs the nerves by fiddling with the brain to not feel Bain and another one that does some other thing with the spine. All highly scheduled and addictive with the worst side effects. I cannot sleep, walk without a crutch, concentrate, am depressed from the pain and the meds, spend my life in bed because I am drugged out and miserable and in chronic pain. I explain this to the agent. Their response is they waiting for apMA from my GP which they have sent - check with GP no form. Week 5 missed 3 opportunities to have this procedure. Explain to discovery no form received. So I get a form to him and we book another date for Friday as they mention they just need this form and they will treat as urgent 🙄 Friday passes we now on Monday where I have now been moved to Tuesday. I explain to them the pain is excruciating and the Neuro is apprehensive about the amount of these tablets I am now taking as they were a short term relief. So we enter another authorisation which gets approved on Thursday for treatment this Tuesday. Friday morning I get a mail saying no they have now declined it as they need more information from the DR. I explain to discovery and beg and plead with them to please help me as I really cannot see what the hold up is as my GP app**** for the sports benefit with the same motivation. Oh no not good enough they now want more information and explain 4-7 working days turn around. I explain the procedure is booked for tomorrow I am now hysterical and the pain is beyond controllable and I have no meds left as my prescriptions are up. I now get a message it is going to the risk board for assessment *** actually. The pain management which is like an epidural which relieved the pain for a good few months to allow physio and yoga to get my back muscles working , hoping that saves me from 3 operations vs having 3 back operations with a 3 year recovery/ You could have knocked me over with a feather, I cannot comprehend this drama so again I lose my booking . I write this review which I really did not want to do at 2:52 as again I am awake from the pain as I cannot sleep. The agent I spoke to understood that if they read all the communication from the last 9 weeks they can see it’s not pre-existing so I am beyond understanding what they are trying to achieve. I feel so bad as I have lost my marbles with these poor agents who are just doing their jobs as you cannot speak to team leaders or managers or even this lot of forensic/ standard/ risk management people as they don’t take calls only escalations. How many flipping times can something get escalated ????! I explained to them the medication, the pain, the lack of sleep has affected me emotionally and I am struggling to function. I can’t remember anything I get stuck in sentences, my work actually thought I was drunk at work. I explained it’s the meds that makes me spaced out. 🤦♀️🤷🏻♀️🤦♀️ So bye bye appointment for tot day and on a waiting list for 3 weeks as the theatre is full. I will need more than oxy opioids and Valium to keep me calm for my next interaction with this medical aid
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Regards Discovery Health Servicing Team
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
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