1 reviews | Active since May 2012
delay with admission authorization
My Grandfather was admitted to brenthurst clinic as an emergency by a doctor he went for a check up to (as per their hospital and doctors network guidlines)after complaining about feeling dizzy alot, two weeks later the medical aid decides they aren't going to pay despite giving an authorization, my grandfather has now been removed even though still ill as discovery says they are still making a decision about authorization, so while they make a decision my grandfather must wait and die or got a government hospital and die there? Discovery is the worst medical aid ever they would rather let your family members die than to actually do what you pay them to do. If you want your loved ones to die like paupers despite having medical aid then waste your money on this medical aid!
Thank you for your comment.
When a member joins the Scheme, we process the application according to the information disclosed on the application. Once your membership is activated and we receive a request for either in or out of hospital authorisation within a certain period of time our system will automatically pend the request. We will then request further clinical information from your provider. This process is necessary to ascertain whether there were any pre-existing conditions of which we were not aware. We have confirmed that you were contacted telephonically by the Standards Team yesterday and was advised on the protocol that we app**** when making this decision.
We are sorry that we cannot provide you with the answer you seek however can confirm that the information provided is in line with the Scheme rules.
Kind regards
Jashvir
Thank you for your comment.
When a member joins the Scheme, we process the application according to the information disclosed on the application. Once your membership is activated and we receive a request for either in or out of hospital authorisation within a certain period of time our system will automatically pend the request. We will then request further clinical information from your provider. This process is necessary to ascertain whether there were any pre-existing conditions of which we were not aware. We have confirmed that you were contacted telephonically by the Standards Team yesterday and was advised on the protocol that we app**** when making this decision.
We are sorry that we cannot provide you with the answer you seek however can confirm that the information provided is in line with the Scheme rules.
Kind regards
Jashvir