Discovery requesting a R10,000 payment before performed procedure
Good day,
My name is Mark Macrery, ID#*** 082 and my Discovery ***.
I have an issue with a swollen and painful leg. I have gone for MRI scans, gone for blood tests and exhausted my MSA because of all these checks. My doctor, Dr Mujakachi, confirmed that I have a Baker's cyst which needs to be removed and also to have my knee checked as to why there is fluid causing this problem. My Dr and I confirmed on an operation only to be told by Discovery that I need to pay R10,000 in advance as this is not covered by my plan.
I have been with Discovery for over 20years and paying for my Classic Comprehensive plan with, no complaints, whatsoever. I am in pain and where does Discovery expect me to pay R10,000 for a procedure and in spite of a Motivational letter from my Doctor they still refuse to waver this amount. Discovery reported that I needed a PMB confirmation from my Doctor and he has sent all requested documents and cannot understand what more I should do to get this operation provisioned for? I am in pain and all the money I have spent on Discovery and the treatment I am receiving truly makes me unhappy and to be told I need to change plans to get my procedure accepted, is just uncalled for. I really want to log a complaint on how I am being treated and I am truly unhappy as the amount of money I have wasted on Discovery to be told such *******. I need this issue resolved.
Kind regards,
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
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
Thank you for your response.
Discovery says, "Your condition does not meet the clinical entry criteria for a Prescribed Minimum Benefit (PMB) condition" - Could you please define what a PMB condition is and give me an example?If my Doctor felt this was not a PMB condition, would he have sent an email of motivation to get me operated on? This does not make sense.
I have not been to work for 2 weeks now as I cannot walk and when I do, my leg swells terribly and hurts a lot. Is this not a concern to you? If I lose my job because of the condition I am currently in, what then, will it then show you how serious my condition is?
I am disappointed with Discovery and how they take people's conditions lightly. I have been using Discovery for over 20 years and get such terrible feedback and support. You truly disgrace me and I will not let this matter end as is.
Kind regards,
Thank you for your response.
Discovery says, "Your condition does not meet the clinical entry criteria for a Prescribed Minimum Benefit (PMB) condition" - Could you please define what a PMB condition is and give me an example?If my Doctor felt this was not a PMB condition, would he have sent an email of motivation to get me operated on? This does not make sense.
I have not been to work for 2 weeks now as I cannot walk and when I do, my leg swells terribly and hurts a lot. Is this not a concern to you? If I lose my job because of the condition I am currently in, what then, will it then show you how serious my condition is?
I am disappointed with Discovery and how they take people's conditions lightly. I have been using Discovery for over 20 years and get such terrible feedback and support. You truly disgrace me and I will not let this matter end as is.
Kind regards,
Discovery Health Servicing Team
Discovery Health Servicing Team