MM
Marcel M

1 reviews | Active since Oct 2020

23 Apr 2021, 09:31

Dissatisfied Customer

To whom it may concern,

Full name : Marcel Shaun Moonsamy Membership Number : *** Identity Number : *** 085 Contact Number : *** / ***

I have been suffering with a septic toe since October 2020. I have been to a General Practitioner (Dr R Rugnuth) five times already. He administered local anesthetic on all occasions and tried cleaning the toe. I was given several different courses of antibiotics which I completed. All of which still has not helped me. My toe is now blue and extremely painful, the doctor confirmed that the toe is septic and not healing. I struggle when wearing closed shoes and my quality of life is not the same due to the extreme pain.

I saw the GP for the below mentioned times for the same issue (septic toe) 1. 29 October 2020 2. 12 November 2020 3. 10 February 2021 4. 24 March 2021 5. 22 April 2021

I have a full doctor's report with my from my GP - Dr R Rugnath.

Upon visiting the GP on 24 March 2021, he then referred me to a specialist surgeon (Dr Kugeshan Govender). I visited this specialist on 16th April. He advised me that I would need to be booked in for 1 day at a hospital and taken into theatre. He went further into explaining that he would need to provide me with anesthetic that would put me off to sleep, cut half of the toe nail and clean out the toe and whatever is making it septic. He advised that I would be discharged the same day.

This specialist app**** for preauthorization for me to be admitted in hospital for 1 day however that was declined. We called the medical aid on 20 April 2021 at 13:12 and spoke to a consultant who advised that the authorization was declined as The medical aid scheme advised that this procedure could be done in a doctor’s room.

As mentioned above, I have visited a GP 5 times already for the same issue, the issue has not progressed but in fact digressed over these past months. Also, the specialist surgeon (Dr Kugeshan Govender) confirmed that he would need to would put me off to sleep, cut half of the toe nail and clean out the toe and whatever is making it septic. He confirmed that local anesthetic will not help and I would need to be taken into hospital (theatre).

Please can you approve this request?

Thanks

0
Replies (5)
Discovery Health
Discovery Health's reply23 Apr 2021, 09:52
Official
Dear Marcel 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 
MM
Marcel M's update23 Apr 2021, 09:53
Reviewer Update
Thank you
MM
Marcel M's update26 Apr 2021, 08:02
Reviewer Update
Good morning,

Please note that I was called on Friday, 23rd April 2021 and advised that I would need to go for a swab test to confirm that my toe is septic.

I went to my GP and was referred for a swab test, I am going for the test this morning.

The test is approx R335 at Lancet, please advise if you will be covering this test as the lab advised that the medical aid doesn't cover this.

Thanks
Mr Marcel Shaun Moonsamy
Discovery Health
Discovery Health's reply28 Apr 2021, 10:47
Official
Dear Marcel M
 
We have been in touch with you to answer your comments.
 
Regards
Discovery Health Servicing Team
MM
Marcel M's update03 May 2021, 08:34
Reviewer Update
Good morning,

Please note that I sent a copy of the swab test and proof of payment for Lancet Laboratories on Thursday, 29 April 2021 at 09:38am.

I had to pay R335 for the test as the medical aid didn't cover it. Please advise if I will be refunded for this as your company referred me for the test?

Please can you also assist with an update for the hospital authorization?

I am in excruciating pain daily and I am concerned that the bacteria could spread to the rest of my leg.

Thanks