DISCOVERY NOT PAYING - Service Provider / Hospital bills

RE: We have reviewed your authorisation request -WRefNo# ********** 056#- -MailRef# ********** 370#-

NOTE THE BELOW as Discovery Authorized the Procedure for my Daughter and now after the Procedure has been completed and my Daughter stayed at the Life Glynwood for more the 24 hours In Hospital the Medical Aid Discovery Comes back and says that they wil lnot pay and add the the below my Daughter that is 10 Has to go back and remove Pins from her hand and we where told today that we need to pay R850 cash as the Medical aid does not Cover this WHY ?

AT no point when the Authorization was given where we told to have R850 CASH TO PAY for Removal of PINS and the stay at hospital is also not being paid for WHY DO we PAY Discovery every month and get treated like this ?????????????????????????????????? ANSWERES PLEASE

Hi all

Another Frustrating situation , my Daughter wen for a Check-up at the Doctors today and we were told that to Remove the PINS from her hand we need to pay an Amount of R850.00 , in the next 5 weeks when the hard plaster is removed from her hand

My wife is paying a Huge amount every month and hardly use the medical aid and now we are told to pay another amount of R850 to remove pin from her hand , Discovery is Ripping Clients off , my Wife was never advised of this when the Authorisation for the Procedure was Granted and now another R850

I NEED A Responses from your side before my Daughter goes for the removal of the Pins and Hard Plaster from her hand , if I am correct when the authorisation was provided no mention of additional payments and when she took out the medical aid we were told 100% of In Hospital admission is paid for , with regards to the matter at hand it’s not 100% being paid and where **** to

I feel that it’s still the Responsibility of Discovery to Fit the Bill for Everything

Thank You Membership number: ********** 80 Dear Shannon Thank you for contacting us. Claim query When we originally processed your claim from Kumasamba N dated 2018/02/13 for R4 925.79, we rejected the account in full. At the time, we did not pay this claim in full because of the rejection code 6, which states that your plan excludes cover for this claim – we have not paid it. An inquiry for our Claims Assessors to review the account has already been opened. The reference number for the inquiry is ********** 918, which may take up to 5 working days to review and reprocess. I apologise for any inconvenience caused and may you have a lovely day further. If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za Regards Nomfundo Hofman Discovery Health (Pty) Ltd On behalf of Discovery Health Medical Scheme ________________________________________ Fwd: We have reviewed your authorisation request -MailRef# ********** 946#- ________________________________________ • To: Debbie Pather ********** ********** ********** ********** ********** "Cc: ********** ********** Shannon Ram ********** ********** • Subject: Fwd: We have reviewed your authorisation request -MailRef# ********** 946#- • From: debbie Pather ********** • Date: Tue, 6 Mar 2018 09:22:54 +0200 (CAT) • Delivered-to: f ********** ********** • Dkim-signature: v=1; a=rsa-sha256; c=relaxed/relaxed; d=gmail.com; s= ********** 5; h=mime-version:in-reply-to:references:from:date:message-id:subject:to; bh=3AhX8PIzBfK0H8lLtIH41BNrOYGSenz/fOrSEWcSUEo=; b=ZSVDD3C8Oy3Nu6N5Ur0cFlbpWnD/iB+fxufvSa6KyLcec9NGPCoSGzr03936ZGxqQy GcMGW5IIMyMAqRM2MdJhEAnKyfzFPAhOcFL9tTwN0sEjhDB+LuVF9SykQMGU5xCggZBX EHd3Iwu8u4AIZ3cgHn37paZuU2BClmLgxRfTmKZd67RmPRTP67r939IgxefnDrvLdKsL UzsiRIvM0tXBUa4BZZfuGtXpIU34rZqERtQRe27u31N2tVxx3jFuQq+Lpiu5MP7bljpG tBoqjTj3RZ/U1vKzHEg2wlmOkBZZGGdzLx+oey3B3OVhsA8IxZz01VggcoL6UEg51Yg6 o8Xg== • In-reply-to: ********** • References: < ********** 166. ********** . ********** ********** ********** ********** • Resent-from: ********** ________________________________________ Good All Kindly find attachment permission for my Husband Shannon Naboe to have access to all my queries. Regards Debbie Pather ---------- Forwarded message ---------- From: Shannon Ram ********** Date: Mon, Mar 5, 2018 at 8:50 AM Subject: RE: We have reviewed your authorisation request -MailRef# ********** 946#- To: debbie Pather ********** Debbie Pather ********** ********** ********** ********** ********** Cc: ********** ********** Hi all  Note that my wife Received a SMS from the Dr N Kumasamba Office stating that the Procedure that my Daughter wen for at Life The Glynwood , is not being paid for as its Not Covered , I have attached a Copy of the Authorisation Letter for the Procedure   I now need to know what is happening with the Medical Aid and Why is this an Issue now after the Procedure was done and we then received a Authorisation Number , very Disappointing from Discovery   I am also sending this to the Complaints Department at the Medical Schemes   I need answers ,     Thank You  From: debbie Pather ********** Sent: 05 March 2018 08:32 AM To: Debbie Pather; Shannon Ram Subject: Fwd: We have reviewed your authorisation request -MailRef# ********** 946#-  ---------- Forwarded message ---------- From: ********** Date: 13 Feb 2018 11:28 AM Subject: We have reviewed your authorisation request -MailRef# ********** 946#- To: ********** Cc:

 Dear Navamoney Thank you for your request for cover. The attached document explains our decision. How to open the attached documentation You will need Adobe Reader installed on your computer. If you do not have it, please download the Adobe Reader software or copy and paste the following URL address in the address line in your web browser: http://www.adobe.com/products/acrobat/readstep2.html Regards Dr Sinazo Mtimkulu Head of DiscoveryCare | Discovery Health On behalf of Discovery Health Medical Scheme  Disclaimer

This message and any attachments are confidential and intended solely for the addressee. If you have received this message in error, please notify Discovery Health Medical Scheme immediately, telephone number ***. Any unauthorised use, alteration or dissemination of the contents of this email is strictly prohibited. In no event will Discovery Health Medical Scheme or the sender be liable in any manner whatsoever to any person for any loss or any direct, indirect, special or consequential damages arising from use of this email or any linked website, including, without limitation, from any lost profits, business interruption, loss of programmes or other data that may be stored on any information handling system or otherwise from any assurance that this email is virus free even if Discovery Health Medical Scheme is expressly advised of the possibility of such damages. Discovery Health Medical Scheme (registration number 1125) is a registered medical scheme.

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-- Best Regards Debbie Pather ________________________________________