Discovery not paying PMB in full

Please advise on the progress of investigation. Mr Hattingh is quite sick and treatment should be adjusted asap. He might also require ECT as most of his medication is on maximum dose. I need to know if I should lodge a complaint with the medical scheme council?

Just to inform the public that discovery did contact me - thank you Rivash. I was told Mr Hattingh’s psychiatrist should speak to the doctor at discovery who will be able to assist with authorization for admission desperately needed. Dr Korb his psychiatrist contacted discovery who was very unhelpful and said under no circumstances will the assist with admission to a psychiatric hospital. In view of me being a doctor - I know the dire need for him to be admitted to optimize his treatment and most likely receive ECT. However in view of Discovery being unhelpful I will no longer advise any of my patients to join Discovery. I have always advocated for Discovery as I felt they would assist patients, however seeing this is not the case I will absolutely not recommend them again. I am also escalating the complaint to the medical schemes council - because shouldn’t there be payment for PMB conditions despite availability of funds. And each circumstance be evaluated - clearly someone planning suicide requires admission. I want to reiterate that a normal hospital will not be adequate - as Mr Hattingh is on max doses of his treatment which is a very complex regime and will need monitoring by a specialist psychiatrist and not a medical officer who has no knowledge of the different psychiatric medication. The public hospital available is Sebokeng - however they do not have the required medication needed as some of his medication is not on tender. Also extremely important is that I know the doctors at the psychiatric unit at Sebokeng hospital and none of them are specialist psychiatrists - only medical officers who cannot be expected to deal with such a complex case.

I would also like to add that it seems as if there is ************** against mental health - as far as I’m aware there is no limit on heart attacks - its not like if someone has had a heart attack in the year - that discovery says: “sorry sir your benefit for heart attack treatment has been depleted - why? Because it causes death. So why when it comes to suicide there is no adequate intervention - because as far as I know it also causes death. According to the South African government website on average 3000 people commit suicide every day. In view of the discovery doctor declining admission for the patient I would like to talk with him/her as doctor to doctor to find out what he suggests as management and how he suggests the treatment should be changed dor the patient to improve. Seeing that he knows more than a psychiatrist- after a psychiatrist requested admission the doctor decided the psychiatrist does not know what he is talking about and declined admission. I also want the name and surname of the doctor who declined admission from discovery side.