Cannot differentiate between 2 PMB's
<p>It seems that Discovery is unable to do ANYTHING without it being a total mess up!!!<br /><br /></p> <p>I submitted two seperate PMB's for Approval for two DIFFERENT claims. <br /><br />I submitted a PMB for STEPS (Boots, Bar and Socks). That has been finalised, on the 2nd of December I submitted the PMB for the actual doctor who did the treatment process of the Casting and Casts prior to the BnB. <br /><br />This morning I spoke to Tulele, who actually seems to be the most competent person in your Call Centre who could actually pick up there were two and noticed that since the 2nd of December your PMB Department has done ABSOLUTELY NOTHING on it as yet. <br /><br />She has escalated this with a flag so that the turnaround time is 2 working days for them to come back to me and then 2 more weeks to sort it out? <br /><br />I see this as a BLATANT delaying tactic to ensure that you can deduct this in my new years deductions. I'm going on leave the 15th and as YET AGAIN YOUR PMB department has wasted time and working on what they "perceive" as excellent customer service of taking a month to get something done at the risk of my baby's healt. <br /><br />When I spoke to your Call Centre on Friday they could not even get the correct PMB with the reference number YOU gave me : ********** 328. Today Tulele could find all the details on that same reference number.<br /><br />I'm now sitting with claims I cannot submit and your tactical delaying will deplete my funds for next year which I need for the new year's treatment of my baby.<br /><br />Since I'm unable to get anything done by your PMB and I'm not willing to lose MY funds next year due to the PATHETIC service by Discovery I am resorting to this, since not even our HR department nor the Broker our company uses can even get your guys to actually do YOUR WORK! And this will used for record purposes should I need to go to the Medical Councel because of all the pathetic service I have received from day 1 of this process and the mere fact that your staff would withold information such as advising customers of the PMB process and that our son's condition is classified under the Medical Councel as a PMB condition. Even though I have told you of his condition since 2 days after he was born.<br /><br />I want this PMB to be approve with immediate effect since you have had your chance to work through it ... and would like to refer you to code 85H of the Medical Counsel list of conditions covered under the PMB : "85H Con******* dislocation of hip; coxa vara and valga; con******* clubfoot Repair / reconstruction", as well as the following from the Medical Counsel Website :<br /><br />"Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide people with continuous care to improve their health and well-being and to make healthcare more affordable.<br /> <br /><strong>PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of:</strong><br /> <br />- any emergency medical condition;<br />- a limited set of 270 medical conditions (defined in the Diagnosis Treatment Pairs);<br /><br /><br /></p>
Dear trevor-fourie
We apologise for the frustration this has caused.
We will contact you to resolve the matter as soon as we can.
Regards
Discovery Health Servicing Team
Dear trevor-fourie
We apologise for the frustration this has caused.
We will contact you to resolve the matter as soon as we can.
Regards
Discovery Health Servicing Team
Dear trevor-fourie
We can confirm that this matter has been resolved.
Please let us know if you have any questions.
Regards
Discovery Health Servicing Team
Dear trevor-fourie
We can confirm that this matter has been resolved.
Please let us know if you have any questions.
Regards
Discovery Health Servicing Team
The matter has infact not been resolved as per my last e-mail back to the PMB department.
The matter has infact not been resolved as per my last e-mail back to the PMB department.
Dear trevor-fourie
We’ve emailed you to confirm that this matter has been settled.
Please be in touch if you have any other concerns.
Regards
Discovery Health Servicing Team
Dear trevor-fourie
We’ve emailed you to confirm that this matter has been settled.
Please be in touch if you have any other concerns.
Regards
Discovery Health Servicing Team
