1 reviews | Active since Mar 2009
Discovery Health has forgotten what they are supposed to be!!!!
On February 23rd, whilst away for the weekend in Mpumalanga, I fell injuring my left side, dislocating my elbow and injuring my knee. I was taken to the Kiaat Private hospital in Mbombela, Mpumalanga, where X-rays revealed no fractures. No MRI Services were available, so I was given a referral letter for an MRI to be done in Johannesburg. I returned on the 24th, contacted Discovery on the 25th to be told that the MRI would be approved if I had a referral letter. I had a referral letter. On the 26th, I arranged for a friend to transport me to the National Radiology Service. I avoided painkillers that day as I needed to be lucid for accurate results and the findings. However, when contacted by NRS, Discovery declined authorizing the MRI, stating the referring casualty doctors weren’t specialists. Today, on March 3rd, I contacted Discovery for clarification and was told the following: 1. NO authorization is needed for an MRI 2. NO call was received from any service provider since my call on the 25th when the MRI process was clarified to me 3. NO solution offered that I believe to be reasonable and viable. I want someone with, at minimum, a fully developed brain and real empathy (not the **** stuff you are taught to feel on a customer service course) to contact me and have the following answers: 1. Do you think when someone goes to casualty, we have checklist of questions to ask the doctors? When exactly was I supposed to ask the doctor if they are specialists - during the x-rays, when they gave me morphin for the pain or when they were bandaging my arm and bracing my leg? 2. If no authorization is required why is there an entire option on your IVR for MRI authorization. 3. Despite having 3 other people including myself bear witness to the rejected authorization telephonically on the 26th, I was gaslighted by Discovery because your system has no record of the call from NRS. What is wrong with your system? Or your staff? Is this what my monthly installment of almost R6000 pays for because you certainly aren't taking care of me with the monies I pay you? 4. The option provided by your consultant – go to a specialist and get a referral. So, despite being in a difficult position and in pain: a. I must find a specialist. b. Arrange someone to take me to the specialist (either get a friend to take time off work, uber (really!!) or drive myself with injured limbs - this is amazing that it’s expected) c. Most probably, which is always the case with this medical aid, pay the specialist for a letter that tells you exactly what the casualty doctors said in their letter. d. Then go for the MRI and only then e. Only then understand the prognosis and treatment options 5. How is Discovery adding ANY value to my life – what you are currently doing is affecting my mental wellbeing by causing unnecessary stress on top of my physical injuries. I am expected to endure your lack of empathy and assistance that I so diligently pay for every month. A medical aid should do what it says AID when their patrons need MEDICAL. Have you forgotten your purpose Discovery? You should not be operating like we are commodities. Every giant falls because they get arrogant.
1. go to a specialist and get a referral which entails
a. I must find a specialist.
b. Arrange someone to take me to the specialist (either get a friend to take time off work, uber (really!!) or drive myself with injured limbs - this is amazing that it’s expected)
c. Most probably, which is always the case with this medical aid, pay the specialist for a letter that tells you exactly what the casualty doctors said in their letter.
d. Then go for the MRI and only then
e. Only then understand the prognosis and treatment options
or I must get the MRI but Discovery plans to reject payment and then they will ask the casuality doctor's who are not specialist for a letter to support the letter they already provided which Discovery will only then review by their specialists and decide whether or not it was a valid request. Let's forget that there is report in triplicate somewhere that documents my injuries, a claim that they just paid to /kiaat hospital that they took off my savings and also that once they reject, I will be expected to pay the provider myself and Discovery will only then be reviewing and I was told that Discovery can decide that they do not deem that it was necessary for an MRI. I would have paid for my own scans even though I pay Discovery. At minimum R12000 - 2 months fees. Should I not heal properly from these injuries, the cost to fix what should have been caught will be much more than just an MRI!!!! Thanks Discovery Health - I am so glad I have YOU in my corner when I'm down. You just keep kicking!!!
1. go to a specialist and get a referral which entails
a. I must find a specialist.
b. Arrange someone to take me to the specialist (either get a friend to take time off work, uber (really!!) or drive myself with injured limbs - this is amazing that it’s expected)
c. Most probably, which is always the case with this medical aid, pay the specialist for a letter that tells you exactly what the casualty doctors said in their letter.
d. Then go for the MRI and only then
e. Only then understand the prognosis and treatment options
or I must get the MRI but Discovery plans to reject payment and then they will ask the casuality doctor's who are not specialist for a letter to support the letter they already provided which Discovery will only then review by their specialists and decide whether or not it was a valid request. Let's forget that there is report in triplicate somewhere that documents my injuries, a claim that they just paid to /kiaat hospital that they took off my savings and also that once they reject, I will be expected to pay the provider myself and Discovery will only then be reviewing and I was told that Discovery can decide that they do not deem that it was necessary for an MRI. I would have paid for my own scans even though I pay Discovery. At minimum R12000 - 2 months fees. Should I not heal properly from these injuries, the cost to fix what should have been caught will be much more than just an MRI!!!! Thanks Discovery Health - I am so glad I have YOU in my corner when I'm down. You just keep kicking!!!
