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thapelo.cm thapelo.cm

1 reviews | Active since Feb 2017

21 Jun 2021, 15:41

Discovery Medical Aid still refuses to assist me. The Hospital is sending me FINAL NOTICES to pay.

The medical scheme refuses to pay for my child's hospital stay because according to them the admission was not an emergency. and the hospital (Medi-Clinic Nelspruit) is not part of the Delta Network.

1. I took my child to a Pediatrician who immediately deemed it very important to write a letter of admission to a nearby hospital. How am I supposed to tell the DR that it's not an emergency? 2. There are not Delta Network hospitals in Nelspruit, the whole town, nearest Delta Hospital is in Witbank which is about 2hrs or more drive. 3. Why am I now supposed to be liable for Hospital bills whilst pay a lot of money to the scheme monthly without fail.

After the 1st review, they called, requesting a letter from the treating DR explaining why a network facility was not used.

1. It is obvious why a network Hospital was not used. a. The Treating Dr's office is in Nelspruit. b. The Patient was in Nelspruit and needed medical attention. c. The treating Dr admitted the patient at Medi-Clinic Nelspruit. d. The nearest Network facility is in Witbank which is more than 200km from Nelspruit. Given the above facts, why would Discovery want more letters from the Dr? The DR has already written a letter as per their request explaining why the patient had to be admitted. Now they want the DR to write a letter to explain why a Network was not used. I mean this is clearly a way to discourage me. The Dr has work to do than to write endless letters to Discovery, HE DID WRITE A LETTER already.

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Replies (3)
Discovery Health
Discovery Health's reply22 Jun 2021, 07:24
Official
Dear Thapelo C

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.

Regards
Discovery Health Servicing Team
Discovery Health
Discovery Health's reply22 Jun 2021, 08:44
Official
Dear Thapelo C
 
We have been in touch with you to answer your comments.
 
Regards
Discovery Health Servicing Team
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thapelo.cm thapelo.cm's update06 Jul 2021, 12:31
Reviewer Update
Finally, I have been assisted.