TC
Tinashe C

1 reviews | Active since Feb 2015

03 Feb 2021, 14:05

Delays in claim finalisation

I was hospitalised on the 2nd of December and the hospital recieved authorisation prior to my admission. During my hospital stay I was done a CT Scan on a saturday as requested by the admitting doctor and they said keycare doesn't work on weekends and authorisation for that will then be finalised on Monday and it was not going to be an issue because Keycare plus takes care of all hospitalisation related claims. I'm recieving statements from the radiologists claiming that discovery rejected the CT scan claim and I have made more than 10 phone calls to discovery with regards to this and they keep on saying the admitting doctor is supposed to complete a medical assessment form. The doctor says he hasn't received the form. How is this my problem because I followed all the basic requirements as required by my medical aid. I went to a hospital that is within the prescribed network, my medical aid payments are up to date, communication between discovery and their accredited or approved medical practitioners doesn't have anything to do with me as a client. can I have this resolved ASAP. This issue has been escalated several times but till now there is no resolution. I even went to the hospital and spoke to the hospital manager who is willing to assist. Can discovery sort this out please!!!

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Replies (2)
Discovery Health
Discovery Health's reply04 Feb 2021, 07:28
Official
Dear Tinashe 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
Discovery Health
Discovery Health's reply05 Feb 2021, 17:15
Official
Dear Tinashe We have been in touch with you to answer your comments. Regards
Discovery Health Servicing Team