Discovery refusing to pay Specialists for the delivery of my baby

<p>I am on the Classic Delta Saver option which requires that I choose a Network hospital and a doctor which Discovery has a payment arrangement with. I chose the hospital and doctor (in-hospital & out-of-hospital) based on the list that Discovery had supp**** me with. I chose Femina and Dr F Postma.</p> <p> </p> <p>I then made sure to obtain pre-authorisation for hospital stay and got the procedure approved by Discovery for the delivery of my baby. Everything seemed okay then.</p> <p> </p> <p>After the delivery of my baby, who came at a time before he was expected, which meant that this was an emergency delivery, I receive a claim submission email stating that Discovery will NOT pay my Gynaecologist (Dr Postma) because he submitted a code that they do not pay for. I for one do not know anything about codes. All I know is that Dr Postma is the doctor who delivered my baby and expect him to be paid as he is on the Network of doctors for Discovery.</p> <p> </p> <p>I then called the Contact Centre to clarify the above and consultant Lorraine told me that the code under which the Dr submitted they do not pay for. Explained how the birthing happened. She called the Dr to verify and it was understood that I delivered as an emergency, normal birth. She then said she would have the claim reprocessed and the turnaround time would be 3 working days. I have heard nothing from here since then even though she promised to keep me in the loop.</p> <p> </p> <p>Furthermore I received another email stating that the Paeditrician (Dr H C Schuman) would also not be paid for the examination/screening of my newborn baby. Reason copied and pasted from Discovery: Your Plan excludes cover for this claim - we have not paid it.</p> <p> </p> <p>This doctor was referred to by Dr Postma and I had made no prior arrangements with them. All I know, the hospital took care of my and babys' health needs for delivery and post-delivery.</p> <p> </p> <p>Discovery has placed me under a lot of stress and frustration just when I am meant to be recovering at home and taking care of my baby. I for one made certain that the Gynaecologist I chose was one which could be paid by Discovery. I do not understand when they tell me they will not. It is unacceptable. Then why am I paying for this medical aid if it will not pay for the Dr who delivered my baby. Codes are an internal matter that I should not be party to. I delivered normal birth and it was an emergency. Full stop.</p> <p> </p> <p> </p> <p>I am really considering the cancellation of this medical aid as I have received no joy. I am completely disatisfied with the service I have received. </p> <p> </p> <p>Kind regards</p> <p>Sizakele Shingange</p> <p> </p> <p> </p> <p> </p>