SR
Sesh R

1 reviews | Active since Jan 2020

24 Jan 2020, 14:12

Discovery incapable of authorizing admission without technical jargon

Having rejoined Discovery in 2019, I can honestly say their service is beyond pathetic. I'm currently sitting in an E. R. Waiting on an admission on which the authorization was declined because it is now a one year waiting period. Based on a preexisting condition that has nothing to do with the authorization at all. Sadly both the consultant and her manager were only able to quote whatever has been scripted and cannot answer about what happens if the emergency warrants an immediate admission. It apparently takes them 8 hours to send through a PMA followed by a 16 hour review period...for an emergency... Clearly priorities are less important that happily taking our premium for close to a year and only providing a savings plan. My question repeatedly was how does an admission via a gp for a normal admission differ from an emergency admission if the rules of waiting and review are the same. Oh and they also stated it may be an undisclosed condition which is why it has been rejected . Wow, Discovery, quick to take a hard working man's money and accuse them of some type of ***** but can't provide adequate service. Pathetic is an understatement by far. My advice would be to find a service provider who makes an effort instead of telling you come back with an ill person to a hospital in 24 hours when it may be too late.

0
Replies (2)
Discovery Health
Discovery Health's reply24 Jan 2020, 14:46
Official
Dear Sesh Reddy

We received your message and we’re looking into the matter.

Regards
Discovery Health Servicing Team 
SR
Sesh R's update24 Jan 2020, 17:56
Reviewer Update
Thank you for the generic response Discovery Health Servicing Team. However giving me a response after I've had to take the ill person back home is simply not good enough. What would help is quicker turn around time and an actual call to show your clients lives matters. Not 16 hours for a review of a condition that patient has never had before.