Discovery key care not covering knee op

<p>Beginning of July 2017 i was playing sport and hurt my knee. The knee felt as if it had no support and with the advise of other players and especially the ones who have been through this, they said i should see a dr. Waited for the swelling to go down so the following Monday i went through to the Life Glynwood (note that this is within the network), the casualties dr attended to me (staff was great) and then they consulted with the orthopaedic surgeon on call. They admitted me and carried out an MRI (ON MY LEFT KNEE). The surgeon saw me and the outcome was:</p> <p>1. Complete tear of ACL </p> <p>2. Bruising to knee</p> <p>3. Lcl strained</p> <p>as well as things mentioned on the MRI.</p> <p> </p> <p>Went to consult with the surgeon who i saw in hospital at his rooms only to find out he isnt in the network. (Why send him to me if he isnt on the list in the first place?) (This is after spending so much money on consulting him and on physio which he sent me for)</p> <p> </p> <p>I then proceeded to consult with a surgeon who is on the list and he picked up that the MRI report doesnt match up with the MRI scans and on top of my above conditions my meniscus cartliage is badly torn and he needs to operate.</p> <p> </p> <p>Sent through the codes to discovery and they said that large joints are a general exclusion on key care and we need to send a motivation letter as well as the PMB codes.</p> <p> </p> <p>Dr cant see that theres a PMB code for knee however he sent through the motivation and yet they still declined the authorisation. </p> <p> </p> <p>So my question to discovery is:</p> <p>1. Why did you admit me for my knee in the first place?</p> <p>2. Why did the surgeon who isnt on the network see me in hospital?</p> <p>3. Why cover a consultation with a orthopaedic surgeon for knee problems? </p> <p>4. Who is to blame if the MRI report doesnt match the MRI scans as well as what the orthopaedic surgeon says?</p> <p> </p> <p>How would you like me to walk,drive,work etc. With a torn acl ligament, torn cartilage and in a brace and on crutches?</p> <p> </p> <p>If I lose my job because of this will you worry? Will it matter if I no longer can pay discovery and cancel my medical aid? Or am I simply just another member to your scheme? </p> <p> </p> <p>An answer to this will be great. </p> <p> </p> <p>Membership number is available on request. </p> <p> </p> <p>Regards,</p> <p> </p> <p>A very upset member who feels that he is paying for nothing!!!!!!!</p> <p> </p>