Claim Partially Paid Due to Approval - Conflicting Information from Discovery and Hospital

I am extremely frustrated with the handling of my hospital claim and the conflicting information provided.

I was admitted on 27 February under authorisation number ***1. My claim was partially paid with reason code 50022, stating that the treatment was not approved.

However, the treatment was approved on 13 February. The issue appears to be that the treating Doctor was never notified of the approval, resulting in my discharge on the initial auth the approval was requested on.

When I contacted Discovery on 20 February to query the approval, I was told that the hospital had been informed. When I followed up with the hospital, they confirmed that they never received any notification from Discovery.

I also asked Discovery whether a new approval would be required since the approval did not reflect during my initial admission and I had already been discharged. I was advised that no new approval was necessary and that the existing approval simply needed to be attached to the authorisation.

Despite this guidance, the claim has now been processed stating there was no approval, and I have been told to contact the hospital, even though this appears to be an administrative communication issue between Discovery and the hospital.

As a member, it is extremely concerning to be placed in the middle of conflicting information between parties while the claim remains unresolved & partially paid.

I would appreciate urgent assistance in:

1. Correctly linking the approved treatment from 13 February to the authorisation and reassessing the claim. 2. Clarifying why the approval was not properly communicated or attached.

Furthermore there are crickets on the escalation.

Defeated & Annoyed