NM
Nteseng M

1 reviews | Active since Jul 2019

12 Nov 2021, 08:15

Discovery.incometence

I was admitted at hospital from the 15th October till 3rd November, on the 7th I fell from the ladder injured my ankle,on the 8 I had follow up appointment with my surgeon I showed hiim my ankle which was swollen he requested an X-ray which showed I had ankle injury.He refered me to orthopedic .At the orthopedic rooms they called discovery to request emergency authorization,The consultant told the lady at the Dr's room that my specialist benefits are depleted I asked to speak to consultant cause I know I had funds.I asked her when was the last claim on the specialist benefits she said on the 27th October they paid surgeon from my specialist benefits and other doctors .I was shocked cause those dates that paid those doctors I was still admitted it was suppose to be pain from hospital benefits.I was told it's because the hospital.didnt update the authorization on their side it showed I was discharged on the 22nd October the hospital must update my file.then the funds will be reversed to specialist benefits. I spoked to case manager at the hospital she told they have back log but because my case was emergency they will look for my file and update.i went home with the swollen ankle Tuesdays I call the hospital I was told they are on training.Wednesday I called the told me they updated the authorization and file it with discovery,I called discovery I was told that the update take 4 to 8 days I explained to them that my ankle is swollen, painful,and I can't work The consultant said they escalated the matter to case manager they will make exception cause it's emergency.On Thursday still they haven't updated I called discovery again spoken to consultant for more than 30 minutes she told me my file it's not updated I must pay cash at the specialist then claim. I asked her I told her I don't have Cash and my feet it's getting worse can't even walk,she transferrede.to.the department that update files, consultant told me they have backlog I explained.again my situation she put me on hold said she is going to speak to her superior, she came back told me I have been holding for too long he will call me back,after 20minutes she called me and told me that her team leaders are busy with my file she will call again after few minutes .She didn't call me back.Today it's Friday I checked if the mistake was correct nothing I am at home with swollen feet and severe pains can't walk I can't go to Orthopedic surgeon because of discovery incompetence. I have funds on my specialist benefits but I can't see specialist because of discovery.i am so heartbroken and disappointed.

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Replies (2)
Discovery Health
Discovery Health's reply12 Nov 2021, 10:30
Official
Dear Nteseng M

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 reply12 Nov 2021, 15:01
Official
Dear Nteseng

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team