Discovery looking for ways not to pay!!!!!

My son was in hospital from 28 September to 18 October. In hospital he developed a abscess on the ankle.

On the discharged date the nurses in hospital wanted us to bring him back to the hospital for wound care the following week. It was not possible as we stay in a different province. The Dr said it was fine as long as we get a wound care sister to attend to the wound.

I contacted Discovery and to find out what the process is for Discovery to cover the cost for the wound care and was advised that I need a referral letter form the Dr ( who treated him in hospital) as well as photos of the wound. I then sent the info to Discovery.

I received the following ref number: ********** 838

I contacted Discovery on 30 October and spoke to Marchelle. She advised that they are waiting for details from the sister. I explained that the sister works for Ifafi Arrie Nel Pharmacy and does not have her own practice. She contacted the sister as well as the pharmacy, then sent an email requesting the following: REF: ********** 838 REF: ********** 398

Practice number of the pharmacy supplying the wound care materials Quotation for the materials used during the wound care treatment.

The pharmacy sent the info on 2 November 2018.

On Tuesday 6 November I contacted Discovery again as I did not receive anything yet. I was informed that the request for the wound care was APPROVED, they are only waiting for the practice number and NAPPI codes. I said it was sent already. The consultant informed me that it takes 2-5 days for them to upload the details. REF ********** 531

Today i called again and spoke to an agent and then requested to speak to a manager. I was transferred to Ryan Putter REF ********** 786. He informed me they have sent another mail requesting the practice number of the sister. and also tried to contact the sister No one received any mail, not the sister or pharmacy.

I followed up with the sister, she did not receive a message or mail to contact Discovery. The pharmacy also did not receive the mail

I then called Discovery again and spoke to Sue. She said she will follow up and get back to me. Unfortunately I was busy on the line when she called. She left a message regarding the wound care: unfortunately the sister does not have a practice number so discovery are unable to process the accounts for the hospital benefit.

Myself, the sister and the pharmacy have told them that she works for the pharmacy and does not have her own practice. DISCOVERY is looking for ways not to pay the claims.

How can Discovery tell me the request has been approved, they are just waiting for the info, practice number of the pharmacy and nappi codes,and when they receive it , decline the request?

VERY POOR!