1 reviews | Active since Jul 2011
BEWARE - ^^ DISCOVERY CAUSES MENTAL HEALTH PROBLEM
WE ARE ON THE EXECUTIVE PLAN.<br> ---<br> PLEASE BEWARE EVERYBODY OUT THERE. See hello peter complaint thur 4 june 14.15.<br> <br> DISCOVERY MEDICAL AID CAN CAUSE YOU TO HAVE EXTREME MENTAL HEALTH ISSUES. THEY HAVE AUTHORISED A HERNIA SURGERY AND DECLINED THE AUTHORISATION A FEW DAYS AFTER THE SURGERY. WE HAVE DONE NOTHING WRONG. WE DID EVERYTHING WE WERE SUPPOSED TO DO REGARDING THIS AUTHORISATION. NOW WE ARE GOING CRAZY AS THE MEDICLINIC IS SENDING US A R28000.00 ACCOUNT WHICH WAS AUTHORISED BY DISCOVERY HEALTH.<br> <br> NOW \APPARENTLY"THIS PROBLEM IS IN A \""REVIEW\"" SITUATION AND I AM GETTING NO FEEDBACK FROM DISCOVERY MEDICAL AID ABOUT THIS EXCEPT UNTRUTHFUL PHONE CALLS AND I AM NOT RECEIVING THE SO-CALLED PROMISED EMAILS THAT I HAVE BEEN TOLD I WILL BE RECEIVING.<br> <br> I DO NOT KNOW WHAT ELSE TO DO APART FROM COMPLAIN ON HELLO PETER ?????<br> <br> MAYBE MY NEXT STEP NEEDS TO BE CARTE BLANCH COMPLAINTS AS THIS IS ABSOLUTELY DISGUSTING WHEN OUR MEDICAL AID CONTRIBUTION IS OVER R9000.00 PER MONTH. I WILL NOT GO AWAY. THIS MATTER MUST BE RESOLVED LEGALLY.<br> """
Thank you for your comment.
I investigated your query and confirmed that we review hospital admission requests based on the information provided to us by the hospital, provider or member. On 18/03/2015 the hospital requested a hospital admission for 07/05/2015 at the Morningside Medi-Clinic. The hospital admission was approved based on the information provided.
On 08/05/2015 the hospital sent us an update and when we updated the hospital admission with these details the hospital admission was declined. The reason being is that these two procedure codes are a General Scheme Exclusion.
I confirmed we are awaiting additional clinical information to review the hospital admission. Once this information is received, our Medical Review Team will continue to review the hospital admission and provide you with a decision.
Regards
Jashvir
Thank you for your comment.
I investigated your query and confirmed that we review hospital admission requests based on the information provided to us by the hospital, provider or member. On 18/03/2015 the hospital requested a hospital admission for 07/05/2015 at the Morningside Medi-Clinic. The hospital admission was approved based on the information provided.
On 08/05/2015 the hospital sent us an update and when we updated the hospital admission with these details the hospital admission was declined. The reason being is that these two procedure codes are a General Scheme Exclusion.
I confirmed we are awaiting additional clinical information to review the hospital admission. Once this information is received, our Medical Review Team will continue to review the hospital admission and provide you with a decision.
Regards
Jashvir