Discovery ignore life-threatening diagnostic test results

Discovery Health has still not paid for my Hospital in full for my "EMERGENCY" visit, which your ***** division has taken more than 7 weeks to audit - your.most junior staff would know that a broken rib ( with Xray evidence), PMB S22.3 and Hemoptysis - coughing up.blood PMB ICD10 Code R04.2, as well as 4 raised D-dimer Pathology results is an EMERGENCY medical situation. D-dimer is produced by the body to break down blood clots, which, if they reach the heart are DEADLY.

I find it SHOCKING that all weekend ER visits are regarded as " *****ulent" , so that Members don't need to.pay to see their Docors on Monday and pay "out of pocket". I was told it would be "unfair' to other members, to consider MY claim a genuine emergency- even with an Xray of a broken rib above my Mitral Valve, Hesmoptysis, and elevated d-dimer. I had also developed a severe cough, as I could not use my asthma inhaler due to the ezcrtiating pain breathing in, so a bacterial infection had developed in my lung which could quickly lead to pneumonia -a common side-,effect of a broken rib. I wonder how they would assess a Hypoglycemic Coma. ( my husband is a Type 1 Diabetic and so relieved we have private paramedics to treat him) or someone at the ER for an amputated limb from a vehicle accident ? Like what sort of evidence would Discovery require to confirm that the ER visit was *****ulent if ALL weekend ER visits are regarded as suspected ***** ?

In addition, and in BLATENT contravention of Section 8 of The Medical Schemes Act , Discovery has not paid Cape Radiology in full for my CT scan to establish if I had a Pulmonary Embolism.

4 D-,dimer results over 500ng/ml within 6 weeks can NEVER mean that nothing is wrong, and ALL the causes for someone my age are either Chronic or Life Threatening.

My husband and I do not have the money to follow the clinical medical diagnostic algorithm for elevated D-dimer.- RA , Lupus and DIC have been ruled out , leaving a malignancy as a REAL possibility. Let's hope it's cancer and.not a blood clot in my leg or my brain. (I say that.in jest, although it's a possibility).

I am deeply disappointed in Discovery Health after over 20 years of membership. When Dr Jonathan Broomberg and Dr Ryan Noach were CEO, this situation would NEVER have occurred.

I urgently need more diagnostic tests for my elevated d-dimer. I have waited weeks and weeks for a " basket of care" , weeks that I medically cannot afford to wait.

The almost total absence of communication is also shocking.

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